García-Soriano Gemma, Arnáez Sandra, Chaves Antonio, Del Valle Gema, Roncero María, Moritz Steffen
Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Avda. Blasco Ibáñez, 21, 46010 Valencia, Spain.
Agencia Valenciana de Salud, Unidad de Salud Mental, Departamento 04, Avda. Sants de la Pedra, 81, 46500 Sagunto, Spain.
J Affect Disord. 2024 Apr 1;350:636-647. doi: 10.1016/j.jad.2024.01.168. Epub 2024 Jan 20.
Obsessive-compulsive disorder (OCD) is a disabling condition with a high delay in seeking treatment. esTOCma is an app developed to increase mental health literacy (MHL) about OCD, reduce stigma, and increase the intention to seek professional treatment. It is a serious game and participants are asked to fight against the "OCD stigma monster" by accomplishing 10 missions. The aim of this study is to evaluate the effectiveness of this app in a community sample.
A randomized controlled trial with a crossover design was carried out. Participants were randomized to two groups: immediate use (iApp, n = 102) and delayed use (dApp, n = 106) of esTOCma. The iApp group started using the app at baseline until the game was over. The dApp group initiated at 10-days until the game finished. Participants were requested to complete a set of questionnaires at baseline and 10-day, 20-day and 3-month follow-ups.
The Time×Group interaction effect was significant for the primary outcome measures: there was an increase in MHL and intention to seek help, and a decrease in stigma and OC symptoms, with large effect sizes, only after using the app. Changes were maintained (or increased) at follow-up.
The study did not include an active control group and some of the scales showed low internal consistency or a ceiling effect.
This study provides first evidence for the effectiveness of esTOCma as a promising intervention to fight stigma and reduce the treatment gap in OCD.
ClinicalTrials.gov Identifier: NCT04777292. Registered February 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04777292.
强迫症（OCD）是一种致残性疾病，患者寻求治疗的时间往往延迟很久。esTOCma是一款旨在提高对强迫症的心理健康素养（MHL）、减少污名化并增加寻求专业治疗意愿的应用程序。它是一款严肃游戏，参与者需通过完成10项任务来对抗“强迫症污名怪兽”。本研究旨在评估该应用程序在社区样本中的有效性。
进行了一项采用交叉设计的随机对照试验。参与者被随机分为两组：立即使用esTOCma应用程序组（iApp，n = 102）和延迟使用组（dApp，n = 106）。iApp组在基线时开始使用该应用程序，直至游戏结束。dApp组在第10天开始使用，直至游戏结束。要求参与者在基线以及第10天、第20天和3个月随访时完成一组问卷。
对于主要结局指标，时间×组间交互效应显著：仅在使用该应用程序后，心理健康素养和寻求帮助的意愿有所增加，污名化和强迫症症状有所减少，且效应量较大。随访时这些变化得以维持（或增加）。
该研究未包括一个积极对照组，且部分量表显示内部一致性较低或存在天花板效应。
本研究首次证明esTOCma作为一种有前景的干预措施，在对抗污名化和缩小强迫症治疗差距方面具有有效性。
ClinicalTrials.gov标识符：NCT04777292。于2021年2月23日注册，https://clinicaltrials.gov/ct2/show/NCT04777292。
