Quality of Life and Psychosocial Impairment in Obsessive-Compulsive Disorder: The Differential Impact of Sexual and Religious Obsessions

Abstract

Obsessive-Compulsive Disorder (OCD) is a chronic psychiatric condition marked by intrusive thoughts (obsessions) and repetitive behaviours (compulsions) that significantly impair functioning. Among its subtypes, sexual and religious obsessions are often underreported due to stigma and guilt. These obsessions may uniquely affect emotional well-being, leading to psychosocial impairment and reduced QOL. Understanding their clinical impact is critical for developing targeted interventions.

Aim: This study aimed to examine the differential impact of sexual and religious obsessions on clinical correlates (anxiety and depression) and quality of life (QOL) among individuals with Obsessive-Compulsive Disorder (OCD), while also exploring the mediating and moderating roles of these variables.

Methodology: A cross-sectional study was conducted with 100 OCD patients diagnosed per DSM-5 criteria. Standardised scales, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hospital Anxiety and Depression Scale (HADS), and WHO Quality of Life-BREF (WHOQOL-BREF) were used to measure OCD severity, clinical correlates, and QOL. Structural Equation Modelling (SEM), ANOVA, and moderation analysis were applied using SPSS and AMOS software to assess the relationships and effects among variables.

Findings and Results: Moderation analysis revealed that quality of life buffered the impact of religious obsessions on OCD severity (β = -0.350, p = .008), but had no significant moderating effect on sexual obsessions. Additionally, ANOVA results indicated that individuals with sexual obsessions, especially when combined with religious obsessions, reported significantly lower QOL scores across physical, psychological, and social domains (p = .009). Religious obsessions alone were associated with comparatively better QOL.

Suggestions: The findings underscore the need for differentiated and targeted treatment approaches. While interventions for religious obsessions should focus on enhancing QOL, sexual obsessions require stigma-reduction strategies, identity-focused therapy, and culturally sensitive psychoeducation. Incorporating Maslow’s hierarchy of needs and the PERMA model may offer a holistic framework to improve psychological resilience and well-being.