Incidental resolution of pedophilia in a patient undergoing deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD): a case report and long-term follow-up
摘要
Deep brain stimulation (DBS) is a highly effective treatment for severe obsessive-compulsive disorder (OCD) by regulating neural activity within the cortico-striato-thalamo-cortical (CSTC) circuit. However, its effects on co-occurring conditions are not well understood. This report highlights an extraordinary case where DBS, used to treat OCD, unexpectedly resolved pedophilic tendencies in a patient.
Case presentationA 36-year-old man with severe refractory OCD underwent DBS surgery after failing multiple treatments. He also had comorbid pedophilia, diagnosed according to DSM-5 criteria. Following Bed Nucleus of the Stria Terminalis and the Anterior Limb of the Internal Capsule (BNST/ALIC) DBS, his OCD symptoms improved significantly, with a 32% reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score over six months. Notably, his pedophilic desires resolved gradually post-surgery, documented through serial psychiatrist-led clinical interviews conducted across follow-up visits. At 58-month follow-up, both conditions remained in remission without medication. The patient’s autonomy and consent were respected throughout the process.
ConclusionA patient with severe OCD and pedophilia underwent DBS, experiencing significant improvement in OCD symptoms and unexpected resolution of pedophilic desires, raising complex ethical considerations for future treatments.