Digital mental health interventions for obsessive compulsive and related disorders: A brief review of evidence-based interventions and future directions

Individuals with obsessive compulsive and related disorders (OCRDs), including obsessive compulsive disorder (OCD), body dysmorphic disorder (BDD), trichotillomania (hair-pulling disorder), excoriation (skin-picking) disorder, and hoarding disorder, suffer from distressing or impairing obsessive preoccupation and/or time-consuming compulsive behaviors. OCRDs are often severe, chronic, and associated with significant psychiatric comorbidity and functional impairment. Cognitive behavioral therapy (CBT) has been shown to be efficacious for all the OCRDs. However, most individuals with an OCRD do not receive CBT, and of those who do, not all respond or respond fully to treatment. The COVID-19 pandemic has deepened the chasm between those who need mental health care and access to clinical services. Digital mental health interventions (DMHIs) have emerged over the past two decades as a solution to the access to care gap, and acceptance of digital solutions was catalyzed by the pandemic. DMHIs have the potential to address unmet mental health needs by offering scalable, low-stigma, cost-effective solutions. This paper reviews current evidence-based DMHIs for OCRDs and describes areas for future research.

Digital mental health interventions for obsessive compulsive and related disorders: A brief review of evidence-based interventions and future directions

Individuals with obsessive compulsive and related disorders (OCRDs), including obsessive compulsive disorder (OCD), body dysmorphic disorder (BDD), trichotillomania (hair-pulling disorder), excoriation (skin-picking) disorder, and hoarding disorder, suffer from distressing or impairing obsessive preoccupation and/or time-consuming compulsive behaviors. OCRDs are often severe, chronic, and associated with significant psychiatric comorbidity and functional impairment. Cognitive behavioral therapy (CBT) has been shown to be efficacious for all the OCRDs. However, most individuals with an OCRD do not receive CBT, and of those who do, not all respond or respond fully to treatment. The COVID-19 pandemic has deepened the chasm between those who need mental health care and access to clinical services. Digital mental health interventions (DMHIs) have emerged over the past two decades as a solution to the access to care gap, and acceptance of digital solutions was catalyzed by the pandemic. DMHIs have the potential to address unmet mental health needs by offering scalable, low-stigma, cost-effective solutions. This paper reviews current evidence-based DMHIs for OCRDs and describes areas for future research.

The Depression: Online Therapy Study (D:OTS)-A Pilot Study of an Internet-Based Psychodynamic Treatment for Adolescents with Low Mood in the UK, in the Context of the COVID-19 Pandemic.

Introduction: Face-to-face therapy is unavailable to many young people with mental health difficulties in the UK. Internet-based treatments are a low-cost, flexible, and accessible option that may be acceptable to young people. This pilot study examined the feasibility, acceptability and effectiveness of an English-language adaptation of internet-based psychodynamic treatment (iPDT) for depressed adolescents, undertaken during the COVID-19 pandemic in the UK. Methods: A single-group, uncontrolled design was used. A total of 23 adolescents, 16-18 years old and experiencing depression, were recruited to this study. Assessments were made at baseline and end of treatment, with additional weekly assessments of depression and anxiety symptoms. Results: Findings showed that it was feasible to recruit to this study during the pandemic, and to deliver the iPDT model with a good level of treatment acceptability. A statistically significant reduction in depressive symptoms and emotion dysregulation was found, with large effect size, by the end of treatment. Whilst anxiety symptoms decreased, this did not reach statistical significance. Conclusions: The findings suggest that this English-language adaptation of iPDT, with some further revisions, is feasible to deliver and acceptable for adolescents with depression. Preliminary data indicate that iPDT appears to be effective in reducing depressive symptoms in adolescents.

Remote W.A.R.A. Compared With Face-to-Face W.A.R.A.: A Pilot Study.

BACKGROUND: Since the outbreak of the COVID-19 pandemic and its social restriction measures, online therapy is a life-saving possibility for patients with acute stress. Wiring Affect with ReAttach (W.A.R.A.) is a brief psychological intervention aiming to decrease negative affect, that can be offered online. METHODS: We assessed the effect of remote W.A.R.A. on negative affect in 37 patients. Consequently, we compared the effect of remote W.A.R.A. versus face-to-face W.A.R.A on negative affect in a cross-sectional design. RESULTS: W.A.R.A. remote therapy provoked a significant reduction of negative affect with a large effect size (d = 3.08, p < 0.001). However, the reduction on negative affect was smaller than with W.A.R.A. face-to-face. We found a substantial difference between W.A.R.A. remote therapy and W.A.R.A. face-to-face in decrease of negative affect (d = 1.36, p < 0.001). LIMITATIONS: The major limitation of the pilot-study is the sample size of 37 patients. Besides, we designed a numeric rating scale for evaluating negative affect. We investigated the impact on negative affect by assessing "unpleasant feelings." This conceptualization of negative affect might still be a point of discussion. CONCLUSION: The study's findings indicated that W.A.R.A. remote therapy significantly reduced negative affect, but to a lesser extent than W.A.R.A. face-to-face. Nevertheless, W.A.R.A. remote therapy might offer a fast relief, especially when personal contact is difficult.