When religion and obsessive-compulsive disorder collide: treating scrupulosity in Ultra-Orthodox Jews.

Evidence-based practice suggests that clinicians should integrate the best available research with clinical judgment and patient values. Treatment of religious patients with scrupulosity provides a paradigmatic example of such integration. The purpose of this study is to describe potential adaptations to make exposure and response prevention, the first-line treatment for obsessive-compulsive disorder, acceptable and consistent with the values of members of the Ultra-Orthodox Jewish community. We believe that understanding these challenges will enhance the clinician's ability to increase patient motivation and participation in therapy and thereby provide more effective treatment for these and other religious patients.

[1]  B. Thorn,et al.  Evidence-based practice in psychology. , 2006, The American psychologist.

[2]  A. Cohen,et al.  Is thought-action fusion related to religiosity? Differences between Christians and Jews. , 2007, Behaviour research and therapy.

[3]  Greg Hajcak,et al.  The OCI-R: validation of the subscales in a clinical sample. , 2007, Journal of anxiety disorders.

[4]  Apa Presidential Task Force on Evidence-Based Practice Evidence-based practice in psychology. , 2006 .

[5]  S. Friedman,et al.  Cognitive-Behavioral Therapy With Orthodox Jews. , 2006 .

[6]  M. Kozak,et al.  Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. , 2007, The American journal of psychiatry.

[7]  D. Watson,et al.  Hoarding and its relation to obsessive-compulsive disorder. , 2005, Behaviour research and therapy.

[8]  E. Goldman,et al.  Religiosity and obsessive-compulsive behavior in Israeli Jews. , 2005, Behaviour research and therapy.

[9]  C. Pollard Freedom From Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living With Uncertainty, J. Grayson. Jeremy P. Tarcher/Penguin, New York (2003), 302 pp , 2005 .

[10]  Karen M. Schmidt,et al.  Ethnic Identification Biases Responses to the Padua Inventory for Obsessive-Compulsive Disorder , 2005, Assessment.

[11]  David Mataix-Cols,et al.  A multidimensional model of obsessive-compulsive disorder. , 2005, The American journal of psychiatry.

[12]  H. Leonard,et al.  Obsessive-compulsive disorder. , 2003, Child and adolescent psychiatric clinics of North America.

[13]  T. Brown,et al.  The distinctiveness of compulsive hoarding from obsessive-compulsive disorder. , 2005, Journal of anxiety disorders.

[14]  J. Stockman,et al.  Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. , 2004, JAMA.

[15]  JoDean Nicolette I am. , 2004, Family medicine.

[16]  S. Parmet Cognitive-Behavior Therapy, Sertraline, and Their Combination for Children and Adolescents With Obsessive-Compulsive Disorder , 2004 .

[17]  J. Abramowitz,et al.  Association between Protestant religiosity and obsessive–compulsive symptoms and cognitions , 2004, Depression and anxiety.

[18]  Obsessive-compulsive disorder and Jewish religiosity. , 2003, The Journal of nervous and mental disease.

[19]  P. Salkovskis,et al.  The Obsessive-Compulsive Inventory: development and validation of a short version. , 2002, Psychological assessment.

[20]  E. Sanavio,et al.  Religiousness and obsessive-compulsive cognitions and symptoms in an Italian population. , 2002, Behaviour research and therapy.

[21]  D. Greenberg,et al.  Obsessive compulsive disorder in ultra-orthodox Jewish patients: a comparison of religious and non-religious symptoms. , 2002, Psychology and psychotherapy.

[22]  The Obsessive-Complusive Inventory: Development and validation of a short version , 2002 .

[23]  E. Witztum,et al.  Sanity and Sanctity: Mental Health Work Among the Ultra-Orthodox in Jerusalem , 2001 .

[24]  M M Weissman,et al.  The epidemiology and cross-national presentation of obsessive-compulsive disorder. , 2000, The Psychiatric clinics of North America.

[25]  S. Friedman,et al.  Cognitive behavioral treatment of anxiety disorders in Orthodox Jews , 1996 .

[26]  K. Jones Evidence Based Medicine—How to Practice and Teach EBM , 1996 .

[27]  J. Mossi Book Review: The Doubting Disease: Help for Scrupulosity and Religious Compulsions , 1996 .

[28]  A. Okasha,et al.  Phenomenology of obsessive-compulsive disorder: a transcultural study. , 1994, Comprehensive psychiatry.

[29]  M. Weissman,et al.  The cross national epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group. , 1994, The Journal of clinical psychiatry.

[30]  E. Witztum,et al.  The influence of cultural factors on obsessive compulsive disorder: religious symptoms in a religious society. , 1994, The Israel journal of psychiatry and related sciences.

[31]  P. Watkins,et al.  Comparative efficacy of religious and nonreligious cognitive-behavioral therapy for the treatment of clinical depression in religious individuals. , 1992, Journal of consulting and clinical psychology.

[32]  G. Steketee,et al.  Religion and guilt in OCD patients , 1991 .

[33]  Kim Sw,et al.  New findings in obsessive-compulsive disorder. , 1989 .

[34]  M. Dysken,et al.  New findings in obsessive-compulsive disorder. , 1989, Minnesota medicine.

[35]  E. Sanavio Obsessions and compulsions: the Padua Inventory. , 1988, Behaviour research and therapy.

[36]  S. Khanna,et al.  Phenomenology of obsessions in obsessive-compulsive neurosis. , 1988, Psychopathology.

[37]  C. Dugovic,et al.  Effects of lithium on dopamine behavioural supersensitivity induced by rapid eye movement sleep deprivation. , 1988, Neuropsychobiology.

[38]  S. Khanna,et al.  Towards a classification of compulsions in obsessive compulsive neurosis. , 1987, Psychopathology.

[39]  M. Tsuang,et al.  Clinical characteristics and family history in DSM-III obsessive-compulsive disorder. , 1986, The American journal of psychiatry.

[40]  D. Greenberg Are religious compulsions religious or compulsive: a phenomenological study. , 1984, American journal of psychotherapy.

[41]  M. Jenike Obsessive compulsive disorder. , 1983, Comprehensive psychiatry.