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Here are the two most notable recent OCD case reports from PubMed (2025):

Recent OCD Case Reports (2025)

1. OCD + Temporal Lobe Porencephaly — First-Ever Reported Case

Deng et al., BMC Psychiatry, April 2025 | PMID: 40197244
Patient: Young male with a structural brain abnormality — left temporal lobe porencephaly (a cavity/cyst in the temporal lobe) — who developed classic OCD symptoms.
Key findings:
  • Cognition was largely intact; social functioning well maintained despite the structural lesion
  • This is the first documented case linking OCD to temporal lobe porencephaly
  • Challenges the dominant cortico-striato-thalamo-cortical (CSTC) circuit model of OCD, suggesting temporal lobe structural abnormalities may also be implicated
Treatment & outcome:
  • Treated with sertraline + aripiprazole + fluvoxamine
  • Improved on medication but relapsed repeatedly after drug withdrawal
  • Responded well again upon reinitiation — highlighting the need for maintenance pharmacotherapy in organic/secondary OCD
Clinical significance: Raises important questions about how temporal lobe lesions can drive OCD phenomenology and how long maintenance treatment should continue in structural/organic OCD.

2. OCD + Kratom Dependence Treated with Buprenorphine

Teixeira et al., BMJ Case Reports, June 2025 | PMID: 40518266
Patient: Man in his 30s presenting to a community drug and alcohol service with problematic Kratom (Mitragyna speciosa) use — which he had started to self-medicate his OCD symptoms and low mood.
Key findings:
  • Kratom has dose-dependent stimulant and opioid-like effects
  • Despite multiple attempts, he could not independently discontinue use
  • This case illustrates how untreated or under-treated OCD drives substance misuse as self-medication
Treatment & outcome:
  • Low-dose sublingual buprenorphine initiated → complete Kratom abstinence within 3 weeks
  • Case emphasizes the complexity of managing comorbid psychiatric and addiction disorders
  • Calls for integrated psychiatry within multidisciplinary addiction services
Clinical significance: Highlights a growing pattern of Kratom use as OCD self-medication and supports a role for buprenorphine in managing Kratom withdrawal.

Context from Neurology Textbooks

Both cases align with — and extend — established understanding:
  • OCD is classically linked to CSTC circuit dysfunction (orbitofrontal cortex, caudate, thalamus)
  • First-line treatment remains SSRIs (sertraline, fluvoxamine) ± augmentation with atypical antipsychotics (aripiprazole)
  • Secondary/organic OCD from brain lesions is a recognized but rare phenomenon (Bradley and Daroff's Neurology; Adams and Victor's Principles of Neurology)
Bottom line: The most clinically novel recent case is the OCD + temporal lobe porencephaly report — the first of its kind, challenging existing neurobiological models and raising questions about long-term maintenance treatment in structural OCD.
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