Religious coping and medication adherence among Muslim outpatients with schizophrenia in Morocco: a cross-sectional study

Abstract Background Religious coping may influence health behaviors, including adherence to long‑term antipsychotic treatment. Evidence from Muslim-majority contexts remains limited. We examined the association between religious coping and medication adherence among Muslim outpatients with schizophrenia in Morocco. Results Forty outpatients (mean age 41.6 ± 9.8 years; 69.2% male (among participants with non-missing sex)) were assessed using the Brief RCOPE (positive and negative coping), the Medication Adherence Rating Scale (MARS; range 10–20), and the Psychotic Symptom Rating Scales (PSYRATS). Mean scores were 16.6 ± 5.5 for positive coping and 11.1 ± 4.9 for negative coping; mean MARS total was 15.4 ± 2.1. In multiple linear regression predicting MARS, both positive coping (B = 0.115, p = 0.045) and negative coping (B = 0.208, p = 0.006) were positively associated with adherence, while delusion severity was negatively associated (B = − 0.205, p = 0.015). The model explained 39.4% of the variance in adherence (R²=0.394; F(4,35) = 5.69, p = 0.001). Conclusions In this small sample of Moroccan Muslim outpatients with schizophrenia, higher religious coping—both positive and negative patterns—was associated with higher self‑reported adherence, whereas more severe delusions were associated with poorer adherence. Clinicians may benefit from culturally sensitive assessment of patients’ religious coping and its clinical meanings.