Psychotherapies for the treatment of scrupulosity: a systematic review

“Scrupulosity” is a common but understudied subtype of obsessive-compulsive disorder (OCD) characterized by religious obsessions and compulsions. Although scrupulosity is a common manifestation of OCD, it has not been adequately addressed in treatment studies. The aim of this study was to understand the conceptual nuances of scrupulosity, its diagnosis, the unique differences in conceptualization and interventions during its treatment, the specific tools needed to monitor the prognosis of the pathology, and the limitations of existing studies through a systematic review. Following PRISMA guidelines, a literature search was conducted, and 13 relevant studies were found in Google Scholar, Scopus, PubMed, EbscoHost + Ulakbim, Wiley Online Library, ScienceDirect, Taylor & Francis Online, and Web of Science databases. Two researchers independently rated the included articles using the MMAT and then met to compare the ratings. Disagreements were resolved through discussion and consensus was reached. There was a general lack of clarity in the conceptualization, diagnosis, and measurement of the severity of scrupulosity, and the content of religious or cultural interventions in the studies was not always clear. For future studies, further clarification, and systematization of the phenomenological features of scrupulosity and related epidemiological and empirical/experimental treatment research are needed.