Exploring circannual rhythms and chronotype effect in patients with Obsessive-Compulsive Tic Disorder (OCTD) : a pilot study

Background: The aim of this study was to test, through a chronobiologic approach, the existence of a significant circannual rhythm of tics and obsessive-compulsive symptoms in patients with Obsessive-Compulsive Tic Disorder (OCTD). The chronotype effect on tics and OC symptoms during seasons was also studied. Methods: Patients with a diagnosis of OCTD (N = 37; mean age = 18.78 \ub1 8.61) underwent four clinical evaluations: Winter (WIN), Spring (SPR), Summer (SUM) and Autumn (AUT). Tics were evaluated through Yale Global Tic Severity Scale (YGTSS) and OC symptoms through Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Patients\u2019 chronotype was assessed by the Horne-Ostberg morningness-eveningness questionnaire (MEQ), which categorizes subjects according to the individuals'chronotype, being morning-type, evening-type, and neither-type. Results: A statistically significant circannual rhythm was observed for OC symptoms (p = 0.007), with the acrophase occurring between AUT and WIN. Y-BOCS differed along the year (p = 0.0003 and \u3b72p = 0.40) with lower results in SUM compared to WIN (p < 0.05) and AUT (p < 0.01). Tics displayed no circannual rhythm and YGTSS scores were comparable among seasons. Patients were classified as 15 morning-types (40.5%) 15 neither-types (40.5%) and 7 evening-types (19.0%). YGTSS data were similar for all chronotypes while Y-BOCS results were greater during SUM in evening-types than morning-type patients (p < 0.05; 15.7 \ub1 5.2 vs 3.4 \ub1 6.0). Limitations: It is essential to investigate the existence of tics and OC symptoms circannual rhythms over the course of more than one year with a larger sample. Conclusions: OC symptoms displayed a significant circannual rhythm and were influenced by patients\u2019 chronotype. On the contrary, tics resulted similar among seasons and chronotypes

Healthy Eating, Physical Activity, and Sleep Hygiene (HEPAS) as the Winning Triad for Sustaining Physical and Mental Health in Patients at Risk for or with Neuropsychiatric Disorders: Considerations for Clinical Practice

Neuropsychiatric disorders stem from gene-environment interaction and their development can be, at least in some cases, prevented by the adoption of healthy and protective lifestyles. Once full blown, neuropsychiatric disorders are prevalent conditions that patients live with a great burden of disability. Indeed, the determinants that increase the affliction of neuropsychiatric disorders are various, with unhealthy lifestyles providing a significant contribution in the interplay between genetic, epigenetic, and environmental factors that ultimately represent the pathophysiological basis of these impairing conditions. On one hand, the adoption of Healthy Eating education, Physical Activity programs, and Sleep hygiene promotion (HEPAS) has the potential to become one of the most suitable interventions to reduce the risk to develop neuropsychiatric disorders, while, on the other hand, its integration with pharmacological and psychological therapies seems to be essential in the overall management of neuropsychiatric disorders in order to reduce the disability and improve the quality of life of affected patients. We present an overview of the current evidence in relation to HEPAS components in the prevention and management of neuropsychiatric disorders and provide suggestions for clinical practice

Socio-demographic and clinical characterization of patients with obsessive-compulsive tic-related disorder (OCTD) : An Italian multicenter study

© Copyright by Pacini Editore SrlIn the DSM-5 a new "tic-related" specifier for obsessive compulsive disorder (OCD) has been introduced, highlighting the importance of an accurate characterization of patients suffering from obsessive-compulsive tic-related disorder ("OCTD"). In order to characterize OCTD from a socio-demographic and clinical perspective, the present multicenter study was carried out. The sample consists of 266 patients, divided in two groups with lifetime diagnoses of OCD and OCTD, respectively. OCTD vs OCD patients showed a significant male prevalence (68.5% vs 48.5%; p < .001), a higher rate of psychiatric comorbidities (69.4 vs 50%; p < .001) - mainly with neurodevelopmental disorders (24 vs 0%; p < .001), a lower education level and professional status (middle school diploma: 25 vs 7.6%; full-Time job 44.4 vs 58%; p < .001). Moreover, OCTD vs OCD patients showed significantly earlier age of OCD and psychiatric comorbidity onsets (16.1 ± 10.8 vs 22.1 ± 9.5 years; p < .001, and 18.3 ± 12.8 vs 25.6 ± 9.4: p < .001, respectively). Patients with OCTD patients were treated mainly with antipsychotic and with a low rate of benzodiazepine (74.2 vs 38.2% and 20.2 vs 31.3%, respectively; p < .001). Finally, OCTD vs OCD patients showed higher rates of partial treatment response (58.1 vs 38%; p < .001), lower rates of current remission (35.5 vs 54.8%; p < .001) and higher rates of suicidal ideation (63.2 vs 41.7%; p < .001) and attempts (28.9 vs 8.3%; p < .001). Patients with OCTD report several unfavorable socio-demographic and clinical characteristics compared to OCD patients without a history of tic. Additional studies on larger sample are needed to further characterize OCTD patients from clinical and therapeutic perspectives.Peer reviewedFinal Published versio

Une plus grande adh&#233;sion au r&#233;gime m&#233;diterran&#233;en est associ&#233;e &#224; une r&#233;duction des tics et des sympt&#244;mes obsessionnels compulsifs: une s&#233;rie de neuf gar&#231;ons atteints du Trouble du Tic Obsessionnel-Compulsif

Tics and obsessions-compulsions are consistent phenotypes of the Obsessive-Compulsive Tic Disorder (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. We present a series of 9 boys with OCTD from Italy whose unhealthy food habits were corrected through a nutritional counseling. The education focused on promoting a balanced diet through non-specific Mediterranean dietary advices. After one month, YGTSS (Yale Global Tic Severity Scale) and Y-BOCS (Yale-Brown Obsessive Compulsive Scale) scored a significant reduction, but the quality of life diminished. First, we conclude that healthier dietary patterns may be associated with an amelioration of tics and obsessive-compulsive traits in boys who are diagnosed with the same conditions. Second, the impact of nutritional interventions on the quality of patients\u2019 life, especially if underage, should always be considered. Certainly, the treatment of OCTD must be multidisciplinary and should include neuropsychiatrists, clinical psychologists, and nutritionists. The nutritional counseling should be as comprehensive as possible to promote a balanced diet, and inform about nutritional side effects of drugs or potential food-drug interactions

Changes in eating behavior after deep brain stimulation for anorexia nervosa. A case&#160;study

Purpose: The purpose of this study was to evaluate changes in the nutritional status, body image concerns, and eating behaviors occurring in a patient who underwent deep brain stimulation (DBS) of the bed nucleus of the stria terminalis for treatment-refractory anorexia nervosa (AN). Methods: Bilateral DBS of the bed nucleus of the stria terminalis was performed in a 37-year-old woman affected by refractory AN. Pre- and post-surgical evaluations were conducted via an array of validated testing instruments, which took into account the weight variations, body image concerns, eating behavior, quality of life, and nutritional status. Results: Overall, eating behavior-, body image concern-, and nutritional status-related testing instruments demonstrated improvements starting from the first post-operative month. Normal body weight was restored after 4&nbsp;months of stimulation. Discussion: Only a few cases of DBS for AN have been conducted to determine the efficacy of surgery based upon weight variation and psychometric scales for anxiety and affective disorders. In contrast, we have designed a comprehensive approach taking into account the most important aspects of this disease. This approach should be considered in future studies dealing with the neurosurgical treatment of AN

Food Bioactive Compounds and Their Interference in Drug Pharmacokinetic/Pharmacodynamic Profiles

Preclinical and clinical studies suggest that many food molecules could interact with drug transporters and metabolizing enzymes through different mechanisms, which are predictive of what would be observed clinically. Given the recent incorporation of dietary modifications or supplements in traditional medicine, an increase in potential food-drug interactions has also appeared. The objective of this article is to review data regarding the influence of food on drug efficacy. Data from Google Scholar, PubMed, and Scopus databases was reviewed for publications on pharmaceutical, pharmacokinetic, and pharmacodynamic mechanisms. The following online resources were used to integrate functional and bioinformatic results: FooDB, Phenol-Explorer, Dr. Duke's Phytochemical and Ethnobotanical Databases, DrugBank, UniProt, and IUPHAR/BPS Guide to Pharmacology. A wide range of food compounds were shown to interact with proteins involved in drug pharmacokinetic/pharmacodynamic profiles, starting from drug oral bioavailability to enteric/hepatic transport and metabolism, blood transport, and systemic transport/metabolism. Knowledge of any food components that may interfere with drug efficacy is essential, and would provide a link for obtaining a holistic view for cancer, cardiovascular, musculoskeletal, or neurological therapies. However, preclinical interaction may be irrelevant to clinical interaction, and health professionals should be aware of the limitations if they intend to optimize the therapeutic effects of drugs

Assessing response, remission and treatment resistance in patients with Obsessive-Compulsive Disorder with and without Tic Disorders: Results from a multicenter study

Objective Highlighting the relationship between Obsessive Compulsive Disorder (OCD) and Tic Disorder (TD), two highly disabling, comorbid and difficult-to-treat conditions, DSM-5 acknowledged a new "tic-related" specifier for OCD, i.e., Obsessive-Compulsive Tic-related Disorder (OCTD). As patients with OCTD may frequently show poor treatment response, the aim of this multicentre study was to investigate rates and clinical correlates of response, remission and treatment resistance in a large multicentre sample of OCD patients with versus without tics. Methods A sample of 398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from ten different psychiatric departments across Italy. For the purpose of the study, treatment response profiles in the whole sample were analysed comparing the rates of response, remission and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to identify possible factors associated with treatment response. Results The remission group was associated with later ages of onset of TD and OCD. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts emerged in the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement

Socio-demographic and clinical characterization of patients with obsessive-compulsive tic-related disorder (OCTD): An Italian multicenter study

In the DSM-5 a new "tic-related" specifier for obsessive compulsive disorder (OCD) has been introduced, highlighting the importance of an accurate characterization of patients suffering from obsessive-compulsive tic-related disorder ("OCTD"). In order to characterize OCTD from a socio-demographic and clinical perspective, the present multicenter study was carried out. The sample consists of 266 patients, divided in two groups with lifetime diagnoses of OCD and OCTD, respectively. OCTD vs OCD patients showed a significant male prevalence (68.5% vs 48.5%; p &lt; .001), a higher rate of psychiatric comorbidities (69.4 vs 50%; p &lt; .001) - mainly with neurodevelopmental disorders (24 vs 0%; p &lt; .001), a lower education level and professional status (middle school diploma: 25 vs 7.6%; full-Time job 44.4 vs 58%; p &lt; .001). Moreover, OCTD vs OCD patients showed significantly earlier age of OCD and psychiatric comorbidity onsets (16.1 ± 10.8 vs 22.1 ± 9.5 years; p &lt; .001, and 18.3 ± 12.8 vs 25.6 ± 9.4: p &lt; .001, respectively). Patients with OCTD patients were treated mainly with antipsychotic and with a low rate of benzodiazepine (74.2 vs 38.2% and 20.2 vs 31.3%, respectively; p &lt; .001). Finally, OCTD vs OCD patients showed higher rates of partial treatment response (58.1 vs 38%; p &lt; .001), lower rates of current remission (35.5 vs 54.8%; p &lt; .001) and higher rates of suicidal ideation (63.2 vs 41.7%; p &lt; .001) and attempts (28.9 vs 8.3%; p &lt; .001). Patients with OCTD report several unfavorable socio-demographic and clinical characteristics compared to OCD patients without a history of tic. Additional studies on larger sample are needed to further characterize OCTD patients from clinical and therapeutic perspectives