Clinical Case DiscussionsA Case Report of Scrupulosity Presenting as Catatonia in a Patient With Both OCD and OCPDNikjoo, Arya MD; Wright, Chela MD; Kheriaty, Aaron MD Author Information NIKJOO, WRIGHT, and KHERIATY: University of California, Irvine Medical Center, Orange, CA The authors declare no conflicts of interest. Please send correspondence to: Chela Wright, MD, UCI Medical Center, 101 The City Drive South, Orange, CA 92868 (e-mail: [email protected]). Journal of Psychiatric Practice: May 2022 - Volume 28 - Issue 3 - p 265-269 doi: 10.1097/PRA.0000000000000629 Buy Metrics Abstract We present the case of a woman in her 40s with a history of hypothyroidism, a differential diagnosis of major depressive disorder with psychotic features versus bipolar I disorder, catatonia, and anorexia nervosa. The patient was admitted to the hospital for poor oral intake, mutism, and social withdrawal. Administration of lorazepam successfully treated these presenting symptoms. However, on subsequent days, she was found to be reading the Bible almost constantly during waking hours, at the expense of engaging in treatment or interacting with others. The patient’s history and presentation supported the idea that her hyper-religiosity stemmed not from bipolar disorder or psychosis, as previously thought, but rather from a subtype of obsessive-compulsive disorder referred to as scrupulosity. This report summarizes the characteristics of scrupulosity and discusses this potentially deceptive mimic of more commonly seen conditions. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.