du Mortier Johanna A M, van Balkom Anton J L M, Twisk Jos W R, van Oppen Patricia, Visser Henny A D
Department of Research, Mental Health Care Institute, GGz Centraal, Amersfoort, Netherlands.
Department of Psychiatry, Amsterdam University Medical Center (UMC), location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Front Psychiatry. 2025 Jul 21;16:1552691. doi: 10.3389/fpsyt.2025.1552691. eCollection 2025.
In psychiatric disorders, lifestyle factors are known to influence both the development and course of the illness. However, little is known about the longitudinal relationship between lifestyle factors and OCD symptom severity, including the potential bidirectional, prospective association between them. This study examines both the contemporaneous and two-year prospective relationships between lifestyle factors and OCD symptom severity, as well as the reverse relationship-namely, the influence of OCD severity on lifestyle factors.
Longitudinal data spanning six consecutive years were obtained from the Netherlands Obsessive Compulsive Disorder Association study (NOCDA). We examined the lifestyle factors: smoking, alcohol and illicit drug use, physical activity, and body mass index (BMI). Mixed models and Generalized Estimating Equations were employed to analyze the contemporaneous and bidirectional prospective relationships between these lifestyle factors and OCD severity.
Drug and alcohol use, BMI, and physical activity did not exhibit a significant contemporaneous relationship with OCD severity. Smoking was significantly associated with more severe OCD symptoms: however depression influenced this relationship. Using alcohol was significantly associated with lower OCD severity. Among females, alcohol use was significantly associated with lower OCD severity two years later. Moderate and high levels of physical activity were significantly associated with lower OCD symptom severity two years later, whereas other lifestyle factors did not significantly predict future OCD symptom severity. OCD symptom severity did not predict any lifestyle factor, except among females, where higher OCD severity was associated with lower drug use two years later.
Previous studies on other psychiatric disorders have found that unhealthy lifestyle factors are associated with more severe psychiatric symptoms. It appears that OCD might differ in these aspects. In the present study, drug and alcohol use, higher BMI, and a composite score of unhealthy lifestyle factors were not associated with more severe OCD symptoms and did not predict greater symptom severity two years later. However, consistent with findings in other psychiatric disorders, higher levels of physical activity were significantly associated with lower OCD symptom severity two years later. Further research is needed to determine whether increasing physical activity could result in less severe OCD symptoms.
在精神疾病中，生活方式因素已知会影响疾病的发生发展及病程。然而，关于生活方式因素与强迫症症状严重程度之间的纵向关系，包括它们之间潜在的双向、前瞻性关联，我们所知甚少。本研究考察了生活方式因素与强迫症症状严重程度之间的同期及两年前瞻性关系，以及反向关系，即强迫症严重程度对生活方式因素的影响。
从荷兰强迫症协会研究（NOCDA）中获取了连续六年的纵向数据。我们考察了生活方式因素：吸烟、饮酒及非法药物使用、体育活动和体重指数（BMI）。采用混合模型和广义估计方程来分析这些生活方式因素与强迫症严重程度之间的同期及双向前瞻性关系。
药物和酒精使用、BMI及体育活动与强迫症严重程度之间未表现出显著的同期关系。吸烟与更严重的强迫症症状显著相关：然而抑郁会影响这种关系。饮酒与较低的强迫症严重程度显著相关。在女性中，饮酒与两年后较低的强迫症严重程度显著相关。中等和高水平的体育活动与两年后较低的强迫症症状严重程度显著相关，而其他生活方式因素并未显著预测未来的强迫症症状严重程度。强迫症症状严重程度并未预测任何生活方式因素，除了在女性中，较高的强迫症严重程度与两年后较低的药物使用相关。
先前针对其他精神疾病的研究发现，不健康的生活方式因素与更严重的精神症状相关。强迫症在这些方面似乎有所不同。在本研究中，药物和酒精使用、较高的BMI以及不健康生活方式因素的综合评分与更严重的强迫症症状无关，也未预测两年后更严重的症状严重程度。然而，与其他精神疾病的研究结果一致，较高水平的体育活动与两年后较低的强迫症症状严重程度显著相关。需要进一步研究以确定增加体育活动是否会导致较轻的强迫症症状。
