What is it about?

Nine boys suffering from OCTD (Obsessive-Compulsive Tic Disorder), with a mean age of 14.4 ± 2.4 years (11; 18), were admitted non-consecutively at Tourette's Syndrome and Movement Disorders Centre in Milan, Italy between January and March 2018 for an ordinary control of the clinical symptoms. The neurologist and the clinical psychologist visited the patients who all were previously known for being partial treatment-responders. No past interventions, comorbidities, or OC traits that could affect food habits were known. Tic severity with social impairment and OC symptoms were evaluated through the Yale Global Tic Severity Scale (YGTSS) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), respectively. The perceived health-related quality of life (QOL) was also assessed to monitor satisfaction through a visual analog scale for children. A total of 6 out of 9 boys reported to do vigorous sport > 2 times per week. Because of testified unhealthy eating behaviors, patients were referred to the nutritionist for a nutritional evaluation. The MD pattern — i.e. the food lifestyle universally recognized as the healthiest — was assessed through the KIDMED index, which effectively investigates the MD adherence in children and youths between 2 and 24 years old. Because of the low baseline adherence, as evidenced by a mean KIDMED score of 3 ± 1.7 (0-5), patients and their parents were addressed for the nutritional counseling.

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Why is it important?

Tics and obsessions-compulsions are consistent phenotypes of the OCTD, frequently associated with male gender, sensory phenomena, and impulsive behaviors. These clinical symptoms were reported to influence eating behaviors, but literature also showed that food patterns or dietary supplements could alleviate the clinical spectra, thus suggesting the existence of a bidirectional association. It is reasonable to think that healthier eating habits would contribute to promote an overall physical and mental well-being that may positively influence clinical symptoms in patients with the same conditions.

Perspectives

The treatment of OCTD must be multidisciplinary and should include neuropsychiatrists, clinical psychologists, and nutritionists. The role of the nutritional support appears increasingly valuable not only in managing the nutrition-related side effects of drugs or impulsive eating, but it also in ameliorating clinical symptoms. Future studies are required to investigate the effects of specific foods or dietary patterns in larger neuropsychiatric populations, with any nutritional intervention being as comprehensive as possible to include the promotion of a balanced diet, information about nutritional side effects of drugs (e.g. alteration of orexigenic/anorexigenic signals), potential food-drug interactions.

M. Briguglio

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This page is a summary of: Higher adherence to the Mediterranean diet is associated with reduced tics and obsessive-compulsive symptoms: A series of nine boys with Obsessive-Compulsive Tic Disorder, Nutrition Clinique et Métabolisme, September 2019, Elsevier, DOI: 10.1016/j.nupar.2019.04.004.
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