Olfactory Reference Syndrome: a case report

Olfactory reference syndrome (ORS) is a psychiatric condition characterized by the false belief that an individual emits an offensive or foul odour from their body. It causes lot of embarrassment and social impairment to these patients. Treatment options include antidepressants and antipsychotics. Here we present a case of Olfactory Reference Syndrome who responded to combination of antipsychotics and antidepressant.

Síndrome referencial olfatorio (SRO): a propósito de un caso / Olfactory Reference Syndrome (ORS): Presentation of a Case

Paciente de 34 años que, tras un continuo de visitas médicas a diferentes especialidades, consulta en la unidad de psiquiatría por bullying (acoso escolar). El principal motivo de acoso, exclusión y burla es el olor corporal que desprende. La remisión de informes de otras especialidades nos indica que queda descartada cualquier afección dermatológica y ninguna de las otras enfermedades propuestas por la paciente. La entrevista clínica psiquiátrica, así como la utilización de otras técnicas de evaluación y diagnóstico, nos sugirió la realización de un diagnóstico diferencial entre el cuadro obsesivo compulsivo y la psicosis monosintomática.

A 34 year old patient who was seen in the Harassment Psychiatry Unit after a series of medical visits to different specialties. The main reason for his harassment, exclusion and derision was due to his body odor. The reports issued by the other specialties ruled out any dermatological pathology, and any of the other conditions proposed by the patient. The psychiatric clinical interview, including the use of other evaluation and diagnostic techniques, suggested a differential diagnosis between a compulsive obsessive picture and mono-symptomatic psychosis.

Considerações sobre a clínica e o tratamento de uma manifestação incomum do transtorno dismórfico corporal: a síndrome de referência olfatória / Considerations on the clinical picture and treatment of an unusual manifestation of body dysmorphic disorder: the olfactory reference syndrome

Neste relato, descreve-se o caso de um rapaz de 23 anos que apresentava a crença de exalar um odor desagradável proveniente da transpiração e acreditava que incomodava as outras pessoas. O paciente foi medicado com amissulprida associada a técnicas de terapia cognitivo-comportamental (TCC), tendo havido acentuada melhora do quadro clínico. Foram abordados aspectos relativos à nosologia e às manifestações clínicas da síndrome de referência olfatória (SRO), e o seu tratamento foi discutido. Observou-se que experimentos comportamentais envolvendo exposição com desafio às crenças delirantes podem ser úteis no tratamento desse transtorno e que os antipsicóticos, particularmente a amissulprida, podem ser uma boa alternativa aos inibidores de recaptação da serotonina (IRSs) no tratamento da SRO.

We report the case of a 23 year old man who believed he emitted an unpleasant odor from perspiration which he’s believed bothered other people. He was treated with amisulpride in combination with cognitive-behavioral therapy (CBT), and there was marked improvement in the clinical status. Aspects related to the clinical manifestations and nosology of olfactory reference syndrome (ORS) and treatment were discussed. It was noted that behavioral experiments involving exposure with challenge to the delusional beliefs may be useful in the treatment of this disorder, and antipsychotics, particularly amisulpride may be a good alternative to the serotonin reuptake inhibitors (SRIs) in the treatment of ORS.

Two Cases of Olfactory Reference Syndrome / 신경정신의학

Disease identity of dysmorphophobia and olfactory reference syndrome which used to be manifested by a kind of monosymptomatic somatic delusion is not yet established definitely. So many issues such as whether it be regarded as separate disease, or a spectrum of preexisting diseases such as schizophrenia or obsessive compulsive disorder and whether the monosymptom should be considered as a delusion or not are still on debate and the results are controversial. Consequently few is known about the etiology of the disorder.Obvioulsy, somatic delusion in dysmorphophobia and olfactory reference syndrome is the result of cognitive distortion of body image of the self. It reflects symbolic meaning of unresolved psychological conflict by defense mechanisms such as repression, dissociation, symbolization, projection, and so on. Though psychopharmacological and psychotherapeutic treatment modality has been reported, the treatment efficacy is unclear. Prognosis has been reported unfavorable and one of the leading causes has been thought to be treatment noncompliance. The authors experienced 2 cases of olfactory reference syndrome, so reported with literature review.