Dietary treatment of chronic obsessional ruminations.

Chronic obsessional ruminations may prove resistant to psychological treatment because they are not psychological in nature but epiphenomena of brain dysfunction secondary to nutritional factors. The case is described of a chronic, treatment-resistant ruminator who made a dramatic and lasting recovery when a high protein breakfast was added to his elimination diet regimen, undertaken when years of psychological and pharmacological treatment had failed. Biochemical and clinical evidence supports the hypothesis that hypoglycaemia secondary to inappropriate diet was the cause of his disorder. Dietary contributions to obsessional ruminations should probably be sought early on in the assessment of such patients.