THE INFLUENCE OF CULTURAL-FACTORS ON OBSESSIVE-COMPULSIVE DISORDER - RELIGIOUS SYMPTOMS IN A RELIGIOUS SOCIETY

Judaism is one of many religions that demand cleanliness and exactness , inculcate the performance of rituals from childhood and view their n on-performance as wrong or sinful. Rituals concerning cleanliness and exactness are the commonest presentations of OCD. In a sample of 34 ps ychiatric out-patients with OCD in north Jerusalem, religious symptoms were found in 13 of the 19 ultra-orthodox patients, and in one of the 15 non-ultra-orthodox patients. Nine of the 15 OCD patients with reli gious symptoms also had non-religious symptoms. Four main topics of re ligious symptomatology were found: prayer, dietary practices, menstrua l practices and cleanliness before prayer. The dictates of religious c odes regarding these topics are presented and the law is rigorous in i ts demands, in many cases encouraging repeating rituals. Nevertheless, repetitive performance of religious rituals is recognized by OCD suff eres and their rabbis as expressing psychopathology rather than height ened spirituality. The forms of the religious obsessions and the assoc iated rituals in this sample were similar to the presentation of OCD i n non-religious patients. Religion appears not to be a distinctive top ic of OCD, rather it is the setting for the condition in very religiou s patients.