ABSTRACT
INTRODUCTION: The olfactory reference syndrome (ORS) is a condition characterized by the false belief that one emits a foul or offensive body odor. There is no consensus on the validity of this syndrome as an independent clinical entity. PATIENTS AND METHODS: A systematic review of the literature is done (1966-2011) searching for articles about the ORS that included a case report using PsycINFO, PubMed, Medline and ISI Web of Knowledge. Data obtained from 55 cases were analyzed to evaluate clinical consistency and heuristic value of this syndrome. RESULTS: The clinical picture is: social avoidance 60%, depressed mood 42%, 46% anxiety and ideas of reference 44%. In 36% of the 55 cases described an event that is identified as a trigger. The most common treatment is first antidepressants, second antipsychotics and thirdly psychotherapy, with an overall efficiency of 39%. CONCLUSIONS: The ORS is a clinically well defined syndrome, which would support the idea of being included in the appendix of DSM-5, as an independent entity. The avoidance behaviour and the traumatic event are the more consistent data. An integrative model is propose. It also presents the clinical description and results of functional magnetic resonance imaging of a clinical case.
Subject(s)
Hallucinations , Hallucinations/diagnosis , Hallucinations/therapy , Humans , SyndromeABSTRACT
Introducción. El síndrome olfatorio autorreferencial (SOA) es un cuadro caracterizado por la creencia errónea de emitir un olor desagradable que los demás pueden percibir y les resulta ofensivo. No hay un consenso sobre la validez de este síndrome como entidad clínica independiente. Pacientes y métodos. Se ha realizado una revisión sistemática de la bibliografía (1966-2011) de artículos acerca del SOA que incluyesen algún caso clínico utilizando PsycINFO, PubMed, Medline e ISI Web of Knowledge. Se han analizado los datos obtenidos de 55 casos con la finalidad de evaluar la consistencia clínica y el valor heurístico de este síndrome. Resultados. En las características clínicas la evitación social aparece en el 60% de los casos, humor depresivo en el 42%, ansiedad en un 46% e ideas de referencia en un 44%. En el 36% de los 55 casos se describe un acontecimiento que se identifica como desencadenante. El tratamiento más empleado son los antidepresivos, seguido de los antipsicóticos y la psicoterapia, con una eficacia global del 39%. Conclusiones. El SOA es una entidad clínicamente bien definida, lo que apoyaría la idea de incluirla en el apéndice del DSM-5 como entidad independiente. Clínicamente, destaca la conducta de evitación y el acontecimiento traumático como datos más consistentes. Se propone un modelo etiopatogénico integrador. Se presentan datos de resonancia magnética funcional de un caso que cumple los criterios diagnósticos del SOA. Los resultados de la resonancia magnética funcional apuntan a una leve hiperactivación del sistema límbico (AU)
Introduction. The olfactory reference syndrome (ORS) is a condition characterized by the false belief that one emits a foul or offensive body odor. There is no consensus on the validity of this syndrome as an independent clinical entity. Patients and methods. A systematic review of the literature is done (1966-2011) searching for articles about the ORS that included a case report using PsycINFO, PubMed, Medline and ISI Web of Knowledge. Data obtained from 55 cases were analyzed to evaluate clinical consistency and heuristic value of this syndrome. Results. The clinical picture is: social avoidance 60%, depressed mood 42%, 46% anxiety and ideas of reference 44%. In 36% of the 55 cases described an event that is identified as a trigger. The most common treatment is first antidepressants, second antipsychotics and thirdly psychotherapy, with an overall efficiency of 39%. Conclusions. The ORS is a clinically well defined syndrome, which would support the idea of being included in the appendix of DSM-5, as an independent entity. The avoidance behaviour and the traumatic event are the more consistent data. An integrative model is propose. It also presents the clinical description and results of functional magnetic resonance imaging of a clinical case (AU)
