Religious observance and obsessive compulsive washing among Iranian women

• We examined religiosity and the expression of OCD symptoms among women in Iran.
• Religiosity had an impact on age at which OCD washing subtype was first diagnosed.
• Religiosity had an impact on OCD symptom severity at the time of first diagnosis.
• The findings have implications for early diagnosis, management and treatment of OCD.

This study examined relationships between religiosity, scrupulosity, cognitive beliefs and Obsessive–Compulsive Disorder (OCD) among High Religious (HR) and Low Religious (LR) Muslim women with OCD washing subtype (OCD-W) who presented for treatment in Tehran. Four groups of women were recruited for the study: HR Muslim women with OCD washing subtype (n=33); HR Muslim women without OCD (n=45); LR Muslim women with OCD-W (n=31); LR Muslim women without OCD (n=30). The OCD-W group had higher scores than the non-OCD group on measures of scrupulosity and beliefs. The HR group had higher scores on religiosity, scrupulosity and beliefs than the LR group. Compared to LR Muslim women with OCD, HR Muslim women were first diagnosed with OCD symptoms at a later age, their OCD symptoms were of maximum intensity at a later age, first sought help for OCD at a later age, were older at the time of their last visit to a health professional, were less likely to have been previously treated for OCD and scored higher on self-report measures of OCD symptomatology at the time of assessment. These findings have implications for models of OCD scrupulosity and for early diagnosis and treatment of OCD for highly religious Iranian Muslim women.