Obsessive-Compulsive Disorder with a Religious Focus: An Observational Study

Background: Obsessive-compulsive disorder (OCD) is a psychiatric disorder with poorly detailed subtypes/dimensions, such as religious OCD (ROCD). To date, little is known about ROCD characteristics. This work aimed to describe the sociodemographic and clinical characteristics, along with the religiosity and spirituality, of Lebanese Muslim citizens diagnosed with OCD and exhibiting religious symptoms. Methods: Participants were Lebanese Muslims, outpatients with OCD and religious symptoms, aged 18 or above, who could complete a questionnaire. Exclusion criteria were as follows: other psychiatric disorders and cognitive or physical impairments preventing participation. They completed a questionnaire including the 25-item Arabic Scale of Obsessions and Compulsions (10 questions addressing obsessions, 10 questions addressing compulsions, and 5 filler items, all of which were rated on a 4-point Likert scale, with higher total scores indicating increasing severity), the 26-item Spiritual Involvement and Beliefs Scale (rated on a 5-point Likert scale, with higher scores indicating higher spirituality), and questions assessing sociodemographic, clinical, and religiosity variables. Results: Fifty adults (62% females, 52% aged between 18 and 29 years) completed the study. They had mild (26%), moderate (48%), and severe (26%) OCD symptoms. The majority attended religious school at least at one point in their life and described a moderate to very high degree of self-religiosity and parental religiosity. Group comparisons (patients with mild vs. moderate vs. severe OCD symptoms) showed significant differences with regard to a family history of psychiatric disorders (p = 0.043), the frequency of self-questioning if they prayed correctly (p = 0.005), a higher rating of partial ablution repetition (p = 0.006), and the frequency of partial ablution repetitions (p = 0.041). No significant group differences were noted with regard to sociodemographic or spirituality outcomes. The prevalence of religious doubts (i.e., self-questioning if praying correctly) and specific rituals (partial ablution repetition) among severe OCD patients were 100% (13/13) and 77% (10/13), respectively. Conclusions: The results suggest a link between specific religious practices and OCD severity, underscoring the need for culturally sensitive approaches in diagnosing and treating ROCD.