Journal Article

DZNE-2026-00079

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Secondary obsessive-compulsive syndromes: a systematic literature review resulting in 228 suspected cases.

Runge, K. ; Feige, B. ; Schiele, M. A. ; von Zedtwitz, K. ; Maier, A. ; Stöcker, N. ; Dressle, R. J. ; Baldermann, J. C. ; Maier, S. J. ; Nickel, K. ; Prüss, H.DZNE* ; Coenen, V. A. ; Voderholzer, U. ; Domschke, K. ; Tebartz van Elst, L. ; Endres, D.

2026
Springer Nature [London]

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Please use a persistent id in citations: doi:10.1038/s41380-025-03395-1

Abstract: Secondary forms of obsessive-compulsive disorder (OCD) have clear underlying organic causes and are recognized as distinct nosological entities in the latest international classification systems. This study aims to provide a systematic overview of published cases of suspected secondary obsessive-compulsive syndromes. A systematic literature search of PubMed, Embase, Web of Science, and PsycINFO was conducted oriented on PRISMA criteria. Cases from case studies/series of patients with suspected secondary obsessive-compulsive syndromes and/or secondary obsessive-compulsive symptoms were included. Cases of obsessive-compulsive symptoms due to pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) were excluded. Overall, 228 cases of suspected secondary obsessive-compulsive syndromes were identified from 189 publications. Causal factors included brain lesions (25.4%), genetic syndromes (24.1%), head trauma (12.3%), autoimmune-inflammatory processes (11.8%), tumors (8.3%), neurodegeneration (7.5%), seizures (4.8%), pathogens (3.9%), metabolic processes (1.3%), or other reasons (0.4%). The age of the affected patients varied considerably (mean 37.3 ± 21.2 years, range 4-94 years, n = 226). Diagnostic abnormalities were identified through brain imaging (magnetic resonance imaging/computer tomography) in 66.2% of the sample and via blood analysis in 23.9%. In cases reporting the regions of the brain involvement, frontal lobe (34.3%) and the basal ganglia (26.5%) were mostly affected. The findings highlight a variety of suspected causes of secondary obsessive-compulsive syndromes, most frequently brain lesions, genetic syndromes, head trauma, and autoimmune-inflammatory processes. Identifying secondary obsessive-compulsive symptoms informed personalized therapies in a subgroup of published cases.

Keyword(s): Adolescent (MeSH) ; Adult (MeSH) ; Child (MeSH) ; Female (MeSH) ; Humans (MeSH) ; Male (MeSH) ; Middle Aged (MeSH) ; Autoimmune Diseases: complications (MeSH) ; Brain (MeSH) ; Obsessive-Compulsive Disorder: etiology (MeSH) ; Obsessive-Compulsive Disorder: diagnosis (MeSH) ; Streptococcal Infections (MeSH)

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Contributing Institute(s):

1. Autoimmune Encephalopathies (AG Prüß)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 10 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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