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Trial Indicates App Helps Treat Behavior Disorder

Man with smartphone

(Tero Vesalainen, Pixabay)

8 June 2020. Results of a clinical trial suggest a smartphone app designed for use in a therapy program helps some people control their obsessive-compulsive disorder. Results of the trial assessing a phone app developed by the company NOCD Inc. in Chicago appeared last month in the journal Behavior Therapy (paid subscription required).

Obsessive-compulsive disorder is a common and chronic condition characterized by uncontrollable thoughts, fears, and mental images that cause anxiety. But these repeated and upsetting thoughts often result in disturbing and disruptive behaviors when they involve other people. Unreasonable concern of contamination, for example, can lead to excessive and repeated hand-washing, or excessive fears can result in aggressive behaviors toward other people or oneself.

Data from National Institute of Mental Health show some 1.2 percent of adults in the U.S. experienced obsessive-compulsive disorder in the past year, with medication and psychotherapy the most common treatments. As reported in Science & Enterprise in August 2018, FDA cleared a non-invasive device using magnetic waves that penetrate the brain to treat obsessive-compulsive disorder.

NOCD developed a smartphone app for people with obsessive-compulsive disorder to use in a therapy program. The app connects the individual with a therapist, who conducts a video assessment and prepares a treatment plan. The therapy uses a technique called exposure and response prevention or ERP. In this therapy, individuals first expose or confront their thoughts, images, objects, or situations causing anxiety or starting an obsession. In response prevention, participants then learn how to make choices not to respond in unproductive compulsive behavior, once the anxiety or obsession is triggered. Users of the app can also send and receive text messages with their therapists.

While clinical evidence shows ERP is as helpful as medication to people with obsessive-compulsive disorder, and continues to reduce unproductive behaviors after treatments, conventional therapy sessions still require an individual to meet in person with the therapist, which limits ERP’s availability. Thus the NOCD app was designed to make ERP therapy more readily available at lower cost to people needing the help.

The clinical trial was a pilot study conducted by clinical psychologists at Columbia University Medical Center in New York and the New York State Psychiatric Institute, led by Marina Gershkovich, professor of medical psychology and practicing psychotherapist. The trial enrolled 33 individuals age 18 to 65 with obsessive-compulsive disorder. Participants received three to five NOCD sessions with the therapist through the app, followed by weekly telephone calls, over an eight-week period. An independent panel rated participants at the beginning, middle, and end of the sessions, then two months after therapy, using a standard rating scale of obsessive-compulsive behaviors. The trial had no control or comparison group.

The results show 14 of the 33 NOCD participants (42%) experienced improved scores on the standard rating scale of 35 percent or more at the end of the therapy, indicating a response to the treatment. Eight of the 33 individuals (24%) also achieved minimal symptoms. After two months, the study team followed up with 20 of the participants, of whom seven met criteria for treatment response and three reported complete remission.

“Although this was an open pilot trial that needs to be followed up to confirm efficacy with a randomized controlled study in a larger sample,” says NOCD founder and CEO Stephen Smith in a company statement released through Cision, “the current results suggest that the combined program is feasible, acceptable, and demonstrates a clinically significant reduction in OCD symptoms.”

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