Efficacy of the Mobile Health App Intellect in Improving Subclinical Obsessive Compulsive Disorder in University Students: Randomized Controlled Trial with a 4-Week Follow-up (Preprint)

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 applications are accessible and affordable interventions, with potential to address subclinical OCD before symptoms escalate. OBJECTIVE In this randomized controlled trial, we examined 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 randomized 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 4-week follow-up. The primary outcome measure was OCD symptom severity (Obsessive Compulsive Inventory – Revised). 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 to the active control group after the intervention (partial eta-squared [ηp2]=0.031; p=.017) 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 post-intervention (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 amongst 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. CLINICALTRIAL ClinicalTrials.gov NCT06202677; https://clinicaltrials.gov/study/NCT06202677