Efficacy of the mHealth App Intellect in Improving Subclinical Obsessive-Compulsive Disorder in University Students: Randomized Controlled Trial With a 4-Week Follow-Up.

BACKGROUND

Obsessive-compulsive disorder (OCD) is the third most prevalent mental health disorder in Singapore, with a high degree of burden and large treatment gaps. Self-guided programs on mobile apps are accessible and affordable interventions, with the potential to address subclinical OCD before symptoms escalate.

OBJECTIVE

This randomized controlled trial aimed to examine the efficacy of a self-guided OCD program on the mobile health (mHealth) app Intellect in improving subclinical OCD and maladaptive perfectionism (MP) as a potential moderator of this predicted relationship.

METHODS

University students (N=225) were randomly assigned to an 8-day, self-guided app program on OCD (intervention group) or cooperation (active control). Self-reported measures were obtained at baseline, after the program, and at a 4-week follow-up. The primary outcome measure was OCD symptom severity (Obsessive Compulsive Inventory-Revised [OCI-R]). Baseline MP was assessed as a potential moderator. Depression, anxiety, and stress (Depression Anxiety and Stress Scales-21) were controlled for during statistical analyses.

RESULTS

The final sample included 192 participants. The intervention group reported significantly lower OCI-R scores compared with the active control group after the intervention (partial eta-squared [ηp2]=0.031; P=.02) and at 4-week follow-up (ηp2=0.021; P=.044). A significant, weak positive correlation was found between MP and OCI-R levels at baseline (r=0.28; P<.001). MP was not found to moderate the relationship between condition and OCI-R scores at postintervention (P=.70) and at 4-week follow-up (P=.88).

CONCLUSIONS

This study provides evidence that the self-guided OCD program on the Intellect app is effective in reducing subclinical OCD among university students in Singapore. Future studies should include longer follow-up durations and study MP as a moderator in a broader spectrum of OCD symptom severity.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06202677; https://clinicaltrials.gov/study/NCT06202677.