Religiosity and obsessive–compulsive phenomena in Turkey: associations with obsessive beliefs and symptom dimensions

Background Leveraging Turkey’s unique socio-cultural context, this cross-sectional study aimed to investigate the specific relationships between religious motivation, dysfunctional cognitive beliefs, and symptom dimensions in individuals with Obsessive-Compulsive Disorder (OCD) compared to healthy controls. Methods The sample comprised 169 participants: a clinical group with primary OCD without current psychiatric comorbidities ( n = 93) diagnosed via SCID-5-CV, and a healthy control (HC) group ( n = 76). Participants completed the Motivational Religiosity Scale (MRS), Obsessive Beliefs Questionnaire (OBQ-44), and Padua Inventory (PI-WSUR). Group comparisons were evaluated using unadjusted t-tests and Analysis of Covariance (ANCOVA) adjusting for sociodemographic confounders (education, income, employment, marital status, alcohol use). Correlation analyses were adjusted for multiple comparisons using the Holm-Bonferroni procedure. Results Unadjusted comparisons showed significantly higher MRS total scores in the OCD group compared to controls (M = 110.85 ± 28.56 vs. 92.75 ± 31.56; t=-3.91, p <.001, Cohen’s d = 0.60). This group difference remained statistically significant in ANCOVA models controlling for sociodemographic covariates (F(1,161) = 9.84, p =.002, partial η2=0.058). In bivariate correlation analyses, religiosity (MRS) correlated positively with overall obsessive beliefs and multiple symptom subscales in healthy controls. Within the clinical OCD group, religiosity demonstrated a robust positive correlation strictly with the OBQ Importance/Control of Thoughts subscale (ρ = 0.381, praw=0.0002, padj=0.002), which was maintained in multivariable linear regression adjusting for sociodemographic confounders (β = 0.341, p =.001). Religiosity was not associated with overall OCD symptom severity (PI-WSUR Total) or broad symptom dimensions in the clinical sample. Conclusion Religious motivation is elevated in primary OCD and displays a domain-specific, selective association with cognitive beliefs regarding the importance and control of thoughts, independent of sociodemographic confounders. Findings suggest that religious motivation interacts with OCD primarily at the cognitive appraisal level rather than acting as a global driver of overall symptom severity.