Effectiveness of Religious-Cognitive-Behavioral Therapy on Religious Oriented Obsessive Compulsive Disorder and its Co-morbidity

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Psychiatry, School of Medicine and Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Resident, Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Associate Professor, Department of Community Medicine, School of Medicine and Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Clinical Psychological Student, Department of Psychology, Khorasgan Branch, Eslamic Azad University, Isfahan, Iran.

5 Medical Student, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Obsessive compulsive disorder (OCD) is a chronic disorder with significant influence on social, emotional, and occupational performances. Although epidemiologic investigations is proved on this disorder in different cultures but obsessive compulsive disorder with religious contents is more prevalent among religious populations such as Middle East Jews and Muslims. Many clinical researches showed therapeutic spiritual interventions could obviously decrease symptoms of patients with depression, anxiety, and obsessive disorder. The aim of this study was to evaluate the efficacy of religious cognitive-behavioral therapy on obsessive compulsive disorder with religious content and its co-morbidities.Methods: In this randomized controlled clinical trial, our intervention consisted of 10 weekly spiritual cognitive-behavioral therapy 90-minutes sessions supervised by both a clergyman and a psychiatrist. Among outpatient obsessive compulsive disorder subjects visited in Noor psychiatric clinic, Isfahan, randomly 50 patients with 17 and more Yale Brown scores and religious content obsessive symptoms were selected and divided into two equal intervention and control groups. Yale Brown, SCL-90, and Hamilton depression questionnaires were used in this study. Data were analyzed by ANOVA/ANCOVA repeated measure tests using SPSS13 software.Finding: Mean age of patients was 32.9 ± 8.86 years. Ninety fore percent of patients (n = 47) were female and remaining were male. Yale Brown scores in three stages (before intervention, after fifth and tenth session) in both groups decreased, specially in intervention group, but showed no significant difference (P = 0.294). However, there were significant differences between mean scores of two groups (P = 0.047). Comparison of obsession subscale and compulsion subscale of Yale Brown scale showed decrease in three stages of the study. Decreasing trend in obsession subscale was not statistically significant (f(2,42) = 0.94; P = 0.398), but decreasing trend in compulsive subscale was (f(2, 43) = 36.008; P < 0.001).Conclusion: In non-responder religious obsessive disorder patients with religious contents, religious based interventions like religious cognitive-behavioral therapy could significantly increase clinical response. Such intervention could improve co-morbid symptoms as well as global severity index (who are worsened clinical response and prognosis of obsessive compulsive disorder) in addition to obsessive symptoms. 

Keywords

References

  1. Rodriguez-Salgado B, Dolengevich-Segal H, Arrojo-Romero M, Castelli-Candia P, Navio-Acosta M, Perez-Rodriguez MM, et al. Perceived quality of life in obsessive-compulsive disorder: related factors. BMC Psychiatry 2006; 6: 20.
  2. Greenberg D, Witztum E, Pisante J. Scrupulosity: religious attitudes and clinical presentations. Br J Med Psychol 1987; 60 (Pt 1): 29-37.
  3. Weissman MM, Bland RC, Canino GJ, Green-wald S, Hwu HG, Lee CK, et al. The cross na-tional epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group. J Clin Psychiatry 1994; 55 Suppl: 5-10.
  4. de Bilbao F, Giannakopoulos P. Effect of reli-gious culture on obsessive compulsive disorder symptomatology. A transcultural study in monotheistic religions. Rev Med Suisse 2005; 1(43): 2818-21.
  5. Fati L, Bolhari J. Clinical features of compulsive intellectual - practice in patients with selected medical centers in Tehran. Journal of Iran University of Medical Sciences 1999; 6(2): 140-52.
  6. Dadfar M, Bolhari J, Malakoti K, bayan Zadeh SA. Prevalence of symptoms of obsessive-compulsive disorder. Quarterly Journal of An-deesheh and Raftar 2001; 7(1-2): 27-32.
  7. Nestadt G, Di CZ, Riddle MA, Grados MA, Greenberg BD, Fyer AJ, et al. Obsessive-compulsive disorder: subclassification based on co-morbidity. Psychol Med 2009; 39(9): 1491-501.
  8. Storch EA, Merlo LJ, Larson MJ, Geffken GR, Lehmkuhl HD, Jacob ML, et al. Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry 2008; 47(5): 583-92.
  9. Astrow AB, Puchalski CM, Sulmasy DP. Reli-gion, spirituality, and health care: social, ethical, and practical considerations. Am J Med 2001; 110(4): 283-7.
  10. Koenig HG. Religion, spirituality, and medicine: how are they related and what does it mean? Mayo Clin Proc 2001; 76(12): 1189-91.
  11. Mental health from the perspective of Monotheistic Religions. Proceedings of the 1st Conference of Religious of Mental Health University of Medical Sciences in Iran; 1997 Dec 24-27; Tehran, Iran; 2001. p. 154.
  12. Need to look at religious values in selected mental health counseling approach. Proceedings of the 1st Conference of Religious of Mental Health University of Medical Sciences in Iran; 2001 Des 24-27; Tehran, Iran; 2001. p. 69.
  13. Konig HJ. Whether religion is beneficial for your health? Of religion on mental health body. Trans. Najafi B. Tehran: Institute for Humanities and Cultural Studies; 2007. p. 10-20.
  14. Kendler KS, Liu XQ, Gardner CO, McCullough ME, Larson D, Prescott CA. Dimensions of religiosity and their relationship to lifetime psychiatric and substance use disorders. Am J Psychiatry 2003; 160(3): 496-503.
  15. Vaccaro B. Spirituality in the Treatment of a Man with Anxiety and Depression. Southern Medical Journal 2007; 100(6): 626-8.
  16. D Souzu R. Do patients expect psychiatrists to be interested in spiritual issues? Australasian psychiatry 2002; 10(1): 44-7.
  17. D'Souza RF, Rodrigo A. Spiritually augmented cognitive behavioural therapy. Australas Psychiatry 2004; 12(2): 148-52.
  18. Azhar MZ, Varma SL, Dharap AS. Religious psychotherapy in anxiety disorder patients. Acta Psychiatr Scand 1994; 90(1): 1-3.
  19. Priester PE. Cognitive behavioral treatment of obsessive-compulsive disorder with religious feature. Proceedings of the 1st international congress on Religion and Mental Health; 2001 Des 24-47; Tehran, Iran 2001. p. 139.
  20. Khodayari Fard M, Abedini Y. Comparison of methods of performance and cognitive behavior therapy and Behavior Therapy with combination drug therapy in obsessive-compulsive disorder. Journal of Psychology and Education 2003; 2(6): 79-145.
  21. Asadollahi Gh, Moallemi Sh, Yaghoobi M, Mahdavi M. Comparison of religious counseling with behavioral therapy in patients with in obsessive-compulsive disorder; the practical content of religious. Proceedings of the 3rd Advice from the perspective of the Islamic Conference; 2001 Jun 22; Tehran, Iran; 2001. p. 105-6.
  22. Faghihi AN, Abedini A. Cognitive disorder therapy of obsessive-compulsive disorder in youth with an emphasis on the practical point of view of Islam. Proceedings of the 3rd Advice from the perspective of the Islamic Conference; 2001 Jun 22; Tehran, Iran; 2001. p. 102-4.
  23. Dagi TF. Prayer, piety and professional propriety: limits on religious expression in hospitals. J Clin Ethics 1995; 6(3): 274-9.
  24. Kaufman AS. Medicine and religion. N Engl J Med 2000; 343(18): 1340-2.
  25. Goodman WK, Price LH, Rasmussen SA, Ma-zure C, Fleischmann RL, Hill CL, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989; 46(11): 1006-11.
  26. Naziri G, Neshan Dadfar M, Karimi A. The role of religious commitment, dysfunctional religious beliefs, guilt, and dysfunctional cognitive beliefs in severity of obsessive-compulsive disorder. Quarterly Journal of Andeesheh and Raftar 2005; 11(42): 283-9.
  27. Azad J, Delavar A, Atash Poor H. Comparison of behavior therapy techniques and drug therapy in reducing practical obsession symptoms. Quarterly of Knowledge and Research in Psychiatry 2003; 5(17): 57-76.
  28. Tuzandeh J. Comparison of performance anxiety control training, drug therapy and their combination in patients with generalized anxiety disorder. [MSc Thesis]. Tehran: Psychiatric Institute; 1993.
  29. Fati L. Comparing the efficacy of confrontation with response prevention, clomipramine and the combination of two methods in the treatment of obsessive-compulsive disorder. [MSc Thesis] Tehran: Psychiatric Institute; 1991. p. 22-35.
  30. Derogatis LR, Rickels K, Rock AF. The SCL-90 and the MMPI: a step in the validation of a new self-report scale. Br J Psychiatry 1976; 128: 280-9.
  31. Mirzaei R. Reliability and validity of scl90 test in Iran. [MSc Thesis]. Tehran: School of Psychology, The University of Tehran; 1980. p. 11-23.
  32. Tolin DF, Maltby N, Diefenbach GJ, Hannan SE, Worhunsky P. Cognitive-behavioral therapy for medication nonresponders with obsessive-compulsive disorder: a wait-list-controlled open trial. J Clin Psychiatry 2004; 65(7): 922-31.
  33. Sica C, Novara C, Sanavio E. Religiousness and obsessive -compulsive cognition and symptoms in an Italian population. Behav Res Ther 2002; 40(7): 813-23.
  34. Miovic M. Spirituality, OCD, and Life-threatening Illness. Southern Medical Journal 2007; 100(6): 649-51.
  35. D'Souza R. The importance of spirituality in medicine and its application to clinical practice. Med J Aust 2007; 186(10 Suppl): S57-S59.
Journal of Isfahan Medical School
Volume 28, Issue 114 - Serial Number 114
September and October 2011
Pages 801-811

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History

  • Receive Date: 29 December 2010
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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