Lifestyle risk factors for obsessive-compulsive symptoms and related phenomena: What should lifestyle interventions target?

OBJECTIVE: Understanding the impact of lifestyle on mental illness symptoms is important for informing psycho-education and developing interventions which target mental and physical comorbidities. Obsessive-compulsive and related disorders can have a significant impact on health-related quality of life and physical health. However, our understanding of the impact of lifestyle on obsessive-compulsive symptoms and broader compulsive and impulsive problematic repetitive behaviours is limited. AIMS: We investigated whether lifestyle factors predicted change in obsessive-compulsive symptoms and problematic repetitive behaviours in a general population sample over a 3-month period. METHODS: Eight hundred thirty-five participants completed an online questionnaire battery assessing lifestyle and mental health. Of these, 538 participants completed the same battery 3 months later. We conducted negative binomial regressions to analyse the association of lifestyle factors at baseline with future (1) obsessive-compulsive symptoms, (2) compulsive problematic repetitive behaviours and (3) impulsive problematic repetitive behaviours, adjusting for baseline obsessive-compulsive symptoms and problematic repetitive behaviours. RESULTS: Lower vegetable (p = 0.020) and oily fish (p = 0.040) intake and lower moderate intensity physical activity (p = 0.008) predicted higher obsessive-compulsive symptoms at follow-up. Higher intake of high-fat foods (p < 0.001) predicted higher compulsive problematic repetitive behaviours at follow-up. No lifestyle factors significantly predicted impulsive problematic repetitive behaviours at follow-up. CONCLUSION: Our results speak to the potential importance of lifestyle quality screening, education and lifestyle interventions (e.g. an anti-inflammatory diet) for individuals experiencing compulsivity-related behaviours and/or symptoms. Further research into potential mechanisms of action will allow for more targeted approaches to lifestyle interventions for transdiagnostic compulsive behaviours.

Compulsivity is measurable across distinct psychiatric symptom domains and is associated with familial risk and reward-related attentional capture.

BACKGROUND: Compulsivity can be seen across various mental health conditions and refers to a tendency toward repetitive habitual acts that are persistent and functionally impairing. Compulsivity involves dysfunctional reward-related circuitry and is thought to be significantly heritable. Despite this, its measurement from a transdiagnostic perspective has received only scant research attention. Here we examine both the psychometric properties of a recently developed compulsivity scale, as well as its relationship with compulsive symptoms, familial risk, and reward-related attentional capture. METHODS: Two-hundred and sixty individuals participated in the study (mean age = 36.0 [SD = 10.8] years; 60.0% male) and completed the Cambridge-Chicago Compulsivity Trait Scale (CHI-T), along with measures of psychiatric symptoms and family history thereof. Participants also completed a task designed to measure reward-related attentional capture (n = 177). RESULTS: CHI-T total scores had a normal distribution and acceptable Cronbach's alpha (0.84). CHI-T total scores correlated significantly and positively (all p < 0.05, Bonferroni corrected) with Problematic Usage of the Internet, disordered gambling, obsessive-compulsive symptoms, alcohol misuse, and disordered eating. The scale was correlated significantly with history of addiction and obsessive-compulsive related disorders in first-degree relatives of participants and greater reward-related attentional capture. CONCLUSIONS: These findings suggest that the CHI-T is suitable for use in online studies and constitutes a transdiagnostic marker for a range of compulsive symptoms, their familial loading, and related cognitive markers. Future work should more extensively investigate the scale in normative and clinical cohorts, and the role of value-modulated attentional capture across compulsive disorders.

Hippocampal glutamate is increased and associated with risky drinking in young adults with major depression.

BACKGROUND: Risky drinking in young people is harmful, highly prevalent and often complicated by comorbid mental health problems that compound alcohol-induced impairment. The hippocampus and the glutamate system have been implicated in the pathophysiology of alcoholism and depression. This study aimed to determine whether risky drinking is associated with glutamate levels recorded within the hippocampus of young adults with major depression. METHODS: Sixty-three young persons with major depression (22.1±3.1 years; 65% female) and 38 healthy controls were recruited. Participants completed the alcohol use disorder identification test and underwent proton magnetic resonance spectroscopy to measure in vivo glutamate levels within the hippocampus following a period of at least 48h of abstinence. RESULTS: Young adults with depression had significantly increased hippocampal glutamate levels and a positive association between the level of alcohol use and glutamate. Regression analysis revealed that higher levels of hippocampal glutamate were predicted by having increased levels of risky drinking and depression. LIMITATIONS: Small sample sizes for testing diagnosis by risky drinking interaction and use of creatine ratios rather than the absolute concentrations of glutamate. DISCUSSION: The hippocampus is a critical region; given its role in learning and memory as well as mood regulation, and the neurochemical changes observed in this study may precede structural changes, which are commonly observed in both depression and alcohol misuse. These findings suggest that young adults with major depression who engage in risky drinking may be at increased risk of glutamate excitotoxicity.