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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\u2009\u00b1\u200921.2 years, range 4\u201394 years, n\u2009=\u2009226). 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.<\/jats:p>","DOI":"10.1038\/s41380-025-03395-1","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T13:25:46Z","timestamp":1766496346000},"page":"1121-1131","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Secondary obsessive-compulsive syndromes: a systematic literature review resulting in 228 suspected cases"],"prefix":"10.1038","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0263-4360","authenticated-orcid":false,"given":"Kimon","family":"Runge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9436-1258","authenticated-orcid":false,"given":"Bernd","family":"Feige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam A.","family":"Schiele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"von Zedtwitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Maier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"St\u00f6cker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9408-5196","authenticated-orcid":false,"given":"Raphael J.","family":"Dressle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5851-9268","authenticated-orcid":false,"given":"Juan C.","family":"Baldermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J.","family":"Maier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9863-317X","authenticated-orcid":false,"given":"Kathrin","family":"Nickel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8283-7976","authenticated-orcid":false,"given":"Harald","family":"Pr\u00fcss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1703-6283","authenticated-orcid":false,"given":"Volker A.","family":"Coenen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Voderholzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2550-9132","authenticated-orcid":false,"given":"Katharina","family":"Domschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2274-5447","authenticated-orcid":false,"given":"Ludger","family":"Tebartz van Elst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7322-1195","authenticated-orcid":false,"given":"Dominique","family":"Endres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"3395_CR1","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/S0140-6736(09)60240-3","volume":"374","author":"JS Abramowitz","year":"2009","unstructured":"Abramowitz JS, Taylor S, McKay D. 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