Real-time detection of obsessive-compulsive hand washing with wearables: Research procedure, usefulness and discriminative performance

A smartwatch that automatically detects compulsive actions could help to address the shortcomings of current treatment options for obsessive-compulsive disorder (OCD). We first present our overall research approach to investigate the effectiveness of using a smartwatch as a supplement to cognitive-behavioral therapy (CBT). Second, in a usefulness survey, 82 individuals diagnosed with OCD and 54 therapists answered questions about the degree of usefulness of different aspects of a smartwatch as an adjunct to CBT. Third, in a laboratory study, 23 participants were trained to wash their hands like individuals with OCD (enacted compulsive hand washing) and then asked to clean a cup, to brush their teeth, and to peel a carrot (confounding activities), while wearing a smartwatch. Results of the survey show that the large majority of therapists (94.1%–98.1%) and individuals with OCD (86.5%–93.9%) considered all relevant aspects of a smartwatch that is used as an adjunct to CBT as at least moderately useful. Enacted compulsive hand washing could be discriminated from confounding activities with high sensitivity (0.84) and acceptable specificity (0.79) using a deep learning model. Overall, our findings encouraged us to continue with our research and to test the smartwatch in individuals with compulsive hand washing.