Effectiveness of brief daily training using a mobile app in reducing obsessive compulsive disorder (OCD) symptoms: Examining real world data of “OCD.app - Anxiety, mood & sleep”

Background: Randomized controlled trials (RCTs) indicate that mobile delivered training targeting OCD cognitions is effective in reducing OCD symptoms. However, interventions shown to be effective in RCTs may be less effective in real world settings. Methods: Real world data of “OCD.app - Anxiety, Mood & Sleep” users was collected from October 2020 to June 2022. Users’ OCD symptoms, trait and state mood scores were evaluated at baseline (T0; n = 46,955), payment barrier (T1; n = 13,568), and at the final level (T-final; n = 1732). Results: Dropout rates were higher for women and associated with younger age. Medium effect size reductions in OCI-R scores from T0 to T1 (Cohen's d = 0.37) and medium-large (Cohen's d = 0.66) reductions from T0 to T-final were found. Effects remained when controlling for demographic data and mood and were strongest for users with severe OCD symptoms. Clinically significant improvement (OCI-R change ≥21) was found in 16% of users with severe OCD symptoms. Although stable user traits were prominent moderators of change following short-term use, app usage indicators were more notable over longer training periods. Conclusions: Real world data supports the effectiveness of OCD.app for reducing the full range of OCD symptoms.