[Compulsive disorder with homicidal impulses and paranoid symptoms in vascular encephalopathy]

We report on the case of a 45-year old man with OCD who had the obsessive impulse to kill his 3-year old son. The patient showed signs of vascular encephalopathy after perinatal brain damage; besides that, he had developed a mild "explanatory" delusional system. Under treatment with SSRI and clozapin he improved remarkably. Presenting this case, we discuss the connection between organic disorders and OCD, and especially its relationship to perinatal brain damage.