Evaluating the effectiveness of a collaborative care digital mental health intervention on obsessive-compulsive symptoms in adolescents: A retrospective study.

Objective: 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.

Methods: 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).

Results: 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).

Conclusions: 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.