Is Olfactory Reference Syndrome a Diagnostic Entity Under Obsessive-Compulsive and Related Disorders?: A Case Report

Abstract

Olfactory reference syndrome (ORS) is a rare psychiatric condition involving embarrassment and distress due to persistent mental preoccupation with the idea of emitting body odours foul and offensive enough to disturb others. This disorder is often accompanied by shame, embarrassment, significant distress, avoidance behavior, social phobia and social isolation. The patients may worry that they spread odours originating from their mouth, sweat, genital areas or the gut. This belief may lead the patients to misinterpret the behaviours of others, they may frequently smell themselves, shower and change clothing during the day. There are differences of opinion whether ORS should be considered as a delusional disorder or appear in under the rubric of obsessive-compulsive related disorders. One of the reasons that create this uncertainty is the variation in the response to different treatments. The treatment strategies generally include the use of antipsychotics, the antidepressants, they are preferentially used in combination. In this report we aimed to discuss the case of a 33-year old male patient whose first complaints had been diagnosed 14 years prior, with a diagnosis of OCD with low insight. Shortly after improvement of the OCD symptoms he developed ORS symptoms. We aimed here to discuss the place of ORS in the diagnostic systems with reference to this case.