JMIR Publications

ABSTRACT

Background:

Use of smartphones and wearable biosensors has increased rapidly, with an estimated 87% of adult Americans currently carrying a smartphone and 20% using wearable sensors. These devices can continuously measure various aspects of behavior and physiology, while also collecting data that require user input (such as mood, context, and social interactions). Mobile and wearable technologies have been implemented in healthcare and psychiatry to monitor symptom burden, estimate diagnosis and risk for relapse, predict treatment response, and deliver digital interventions, though the uptake of mobile and wearable devices in psychiatry is varied. Obsessive-compulsive disorder (OCD) is a prevalent and disabling psychiatric condition that often follows a chronic and fluctuating course. Use of mobile and wearable devices in monitoring and treating OCD is highly variable, though these technologies present a novel approach to improving care for individuals suffering from this disorder. Given the speed at which new technologies are developed and implemented in clinical settings, continual reappraisal of this field is needed.

Objective:

In this scoping review we sought to map the literature on the use of wearable- and smartphone-based devices or applications in the assessment, monitoring, or treatment of OCD.

Methods:

We conducted a search of multiple databases including PubMed, EMBASE, APA Psycinfo, and Web of Science from 07/08/2022 – 07/27/2022 using the following search strategy: ("OCD" OR "obsessive" OR "obsessive-compulsive") AND ("smartphone" OR "phone" OR "wearable" OR "sensing" OR "biofeedback" OR "neurofeedback" OR "neuro feedback" OR "digital" OR "phenotyping" OR "mobile" OR "heart rate variability" OR "actigraphy" OR "actimetry" OR “biosignals” OR “biomarker” OR “signals” OR “mobile health”).

Results:

We analyzed 2,487 records, reviewed the full text of 67 articles, and included 21 studies in this review. We divided our review into three parts: 1) studies without mobile/digital intervention and with passive data collection, 2) studies without mobile/digital intervention and with active or mixed data collection, and 3) studies including a digital/mobile intervention.

Conclusions:

Use of mobile and wearable technology in OCD has developed primarily in the past 15 years, with an increasing pace of related publications. Passive measures from actigraphy generally recapitulate subjective report. Ecological momentary assessment is well-tolerated for naturalistic assessment of symptoms, may capture novel OCD symptoms, and may also document lower symptom burden than retrospective recall. Digital or mobile treatments are diverse, though generally provide some improvement in OCD symptom burden. Finally, ongoing work is needed for safe and trusted uptake of technology by patients and providers.