University of Cambridge researchers in the U.K. have developed a smartphone application that shows promise in helping reduce the symptoms of obsessive compulsive disorder (OCD). Investigators reported the brain training app — not yet available to the public — can lead to significant improvements after only one week of use.
Excessive hand-washing and contamination fears are symptoms of a common type of OCD, affecting up to 46 percent of OCD patients. Excessive washing can be harmful as sometimes OCD patients use spirits, surface cleansers or even bleach to clean their hands.
The behaviors can have a serious impact on people’s lives, their mental health, their relationships and their ability to hold down jobs.
The findings from Cambridge Department of Psychology researchers Baland Jalal and Professor Barbara Sahakian, are published in the journal Scientific Reports.
They explain that the repetitive and compulsive behavior is also associated with “cognitive rigidity,” an inability to adapt to new situations or new rules. Ending the compulsive habits, such as excessive hand-washing, requires cognitive flexibility so that the OCD patient can switch to new activities instead.
OCD is traditionally treated using a combination of medication such as Prozac and a form of cognitive-behavioral therapy termed exposure and response prevention. This latter therapy often involves instructing OCD patients to touch contaminated surfaces, such as a toilet, but to refrain from then washing their hands.
These treatments are not particularly effective, however; as many as 40 percent of patients fail to show a good response to either treatment. This may be in part because often people with OCD have suffered for years prior to receiving a diagnosis and treatment.
Another difficulty is that patients may fail to attend exposure and response prevention therapy as they find it too stressful to undertake.
For these reasons, Cambridge researchers developed a new treatment to help people with contamination fears and excessive washing. The intervention, which can be delivered through a smartphone app, involves patients watching videos of themselves washing their hands or touching fake contaminated surfaces.
Ninety-three healthy people who had indicated strong contamination fears as measured by high scores on the Padua Inventory Contamination Fear Subscale participated in the study. The researchers used healthy volunteers rather than OCD patients in their study to ensure that the intervention did not potentially worsen symptoms.
The participants were divided into three groups: the first group watched videos on their smartphones of themselves washing their hands; the second group watched similar videos but of themselves touching fake contaminated surfaces; and the third, control group watched themselves making neutral hand movements on their smartphones.
After only one week of viewing their brief 30 second videos four times a day, participants from both of the first two groups – that is, those who had watched the hand washing video and those with the exposure and response prevention video – improved in terms of reductions in OCD symptoms and showed greater cognitive flexibility compared with the neutral control group.
On average, participants in the first two groups saw their Yale-Brown Obsessive Compulsive Scale (YBOCS) scores improve by around 21 percent. YBOCS scores are the most widely used clinical assessments for assessing the severity of OCD.
Importantly, completion rates for the study were excellent — all participants completed the one week intervention, with participants viewing their video an average (mean) of 25 out of 28 times.
“Participants told us that the smartphone washing app allowed them to easily engage in their daily activities. For example, one participant said ‘if I am commuting on the bus and touch something contaminated and can’t wash my hands for the next two hours, the app would be a sufficient substitute,’” said Jalal.
“This technology will allow people to gain help at any time within the environment where they live or work, rather than having to wait for appointments. The use of smartphone videos allows the treatment to be personalized to the individual,” Sahakian said.
Nevertheless, while these results are exciting and encouraging, the concept requires further research, examining the use of these smartphone interventions in people with a diagnosis of OCD, said Sahakian.
Source: University of Cambridge