Individual placement and support for individuals with obsessive-compulsive disorder

Research problem and specific questionsObsessive-compulsive disorder (OCD) is a serious anxiety disorder affecting about 2% of the population which is associated with substantial disability across a range of domains, including educational attainment and participation in the labour market.

According to data from the Swedish national registers, 44% of individuals with a diagnosis of OCD will be receiving disability pension, be in long-term sickness absence or be long-term unemployed at some point during their employable years.

The overarching purpose of this project is to implement and evaluate the efficacy and cost-effectiveness of Individual Placement and Support (IPS), a person-centred return-to-work program, which has an extensive evidence base in other serious mental disorders but has yet to be evaluated in individuals with OCD.Data and methodThis will be the first evaluation of IPS for OCD anywhere in the world.

We propose to partner with service users, interest organisations, clinicians, employment specialists, and clinic managers to first pilot IPS in specialist OCD services (n=20; AIM 1).

With lessons learnt from the pilot, we will then optimise the delivery of IPS in this clinical context and conduct a fully powered randomised controlled trial of IPS plus standard specialist OCD treatment, compared standard specialist OCD treatment alone (N=110; AIM 2).

Finally, we will evaluate the cost-effectiveness of the intervention from a societal perspective, including a 2-year follow-up in the registers (AIM 3).

Societal relevance and utilisationThis proposal originated as a direct response to a demand from service users who struggle to get on with their lives, even after having received a good treatment for their OCD . Many service users wish to return to work but are unable to.

If successful, this project could represent a new model for the reintegration of individuals with OCD in the labour market, which will not only contribute to the holistic recovery of the individual, but also have clear socioeconomic benefits for society.Plan for project realisationThe project brings together a multidisciplinary team of researchers with a track record in OCD research, clinical trials, return-to-work interventions, biostatistics, health economics, and implementation science.

The team also includes service users and interest organizations that will contribute with their lived experience, as well as health professionals.