Evaluating the effectiveness of a collaborative care digital mental health intervention on obsessive-compulsive...

Obsessive-compulsive (OC) symptoms, characterized by distressing and repetitive thoughts and behaviors, frequently onset during adolescence for individuals with obsessive-compulsive disorder or anxiety disorders. Digital mental health interventions (DMHIs) offer a promising platform to deliver mental health treatment, which may address OC symptoms. The purpose of this retrospective study was to determine the effects of a DMHI, Bend Health, on various domains of OC symptoms, including contamination, responsibility (for harm), unwanted thoughts, and symmetry, in adolescents.

OC symptoms were assessed at baseline (before beginning care) and monthly in adolescents engaged in different care programs involving coaching and/or therapy with the DMHI. Retrospective analyses were used to identify characteristics associated with OC symptoms (N = 2151) and to characterize treatment responsiveness of adolescents with elevated OC symptoms (n = 553).

Adolescents with elevated OC symptoms (32.2%; n = 693 of 2151) were more likely than those with non-elevated OC symptoms to be female (p < .001), to have comorbid symptoms (e.g. anxiety and depression; p < .001), and participate in therapy (p < .001). Further, their caregivers had higher rates of sleep problems and burnout (p < .05). OC symptoms improved for 87.7% (n = 485 of 532) of adolescents during care with the DMHI, and 46.6% (n = 249 of 534) reported clinically substantive improvement. Scores decreased significantly over months in care (t₁₁₈₇ = -8.06, p < .001). Improvements were also identified for OC symptom dimensions (contamination, responsibility (for harm), unwanted thoughts, and symmetry).

Our results deliver compelling preliminary evidence that participation in coaching and therapy with a DMHI may mitigate a variety of OC symptoms for adolescents. Improvements were observed across different OC symptom types, demonstrating the broad applicability of the DMHI to address various presentations and complexities of OC symptoms.