Olfactory Delusional Syndrome with Various Aetiologies

Malasi, T. H.; El-Hilu, S. R.; Mirza, Iman A.; El‐Islam, M. Fakhr

doi:10.1192/bjp.156.2.256

Cited by 46 publications

(45 citation statements)

References 29 publications

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“…[1][2][3][4] The term "olfactory reference syndrome" (ORS) has been introduced to differentiate primary olfactory concerns from those seen as a consequence of other disorders such as schizophrenia, depression or temporal lobe epilepsy. 2 Whether ORS truly is a unique disorder, or merely a part of the symptomatology of other psychiatric conditions, remains controversial.…”

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confidence: 99%

Olfactory reference syndrome: diagnostic criteria and differential diagnosis

Löchner¹,

Vythilingum²,

Stein³

2001

Prim Care Psych

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Abstract:Olfactory reference syndrome (ORS) has been defined as a psychiatric condition characterized by persistent preoccupation about body odour accompanied by shame, embarrassment, significant distress, avoidance behaviour and social isolation.ORS has however not been included in the Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV) and, given that its primary symptoms may be found in various other disorders, differential diagnosis can be problematic.Using an illustrative case of ORS, we propose diagnostic criteria for ORS. We also argue that ORS represents a unique cluster of symptoms that can be delineated as a separate diagnostic entity, and that ORS falls on a spectrum of social anxiety disorders that includes social anxiety disorder, taijin kyofusho, and body dysmorphic disorder. ( Psychiatric patients sometimes present with persistent olfactory concerns or preoccupation with personal odour.1-4 The term "olfactory reference syndrome" (ORS) has been introduced to differentiate primary olfactory concerns from those seen as a consequence of other disorders such as schizophrenia, depression or temporal lobe epilepsy.2 Whether ORS truly is a unique disorder, or merely a part of the symptomatology of other psychiatric conditions, remains controversial.5 ORS is not included in the DSM-IV 6 as a separate category. Arguably, the principal symptomatology of ORS has sufficient overlap with several established anxiety or somatic disorders that a new diagnostic category is not warranted. Conversely, although ORS may have phenomenological overlap with existing DSM-IV disorders, it has also been noted that most patients with primary ORS are young men without concurrent psychiatric disorders. 2In this paper we present a case study (a compilation of different patients with similar symptomatology) to illustrate the diagnostic process when olfactory concerns are prominent. Based on these considerations, diagnostic criteria for ORS are proposed, and other disorders that can be differentiated from ORS, are reviewed. Case HistoryA 22-year-old male who had a 'Western' cultural background, presented with the conviction that he had malodorous breath (halitosis) and a foul body odour emanating from his armpits, feet, and anal region. This persistent preoccupation had begun in early adolescence, but the intensity had increased significantly over the past 7 months.The halitosis complaint was presented as his main concern. In addi- Clomipramine (150 mg daily) prescribed for 12 weeks had little effect.After a dosage increase to 250 mg daily, the patient reported improvement in his preoccupation and that his depressive symptoms had decreased. Cognitive-behavioural therapy was attempted. Despite some progress, he expressed relief when his father advised him to get better "on his own" and he consequently terminated all psychotherapy within 4 weeks. Telephonic follow-up 3 months later revealed that the symptoms remained significantly improved.

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confidence: 99%

Olfactory reference syndrome: diagnostic criteria and differential diagnosis

Löchner¹,

Vythilingum²,

Stein³

2001

Prim Care Psych

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“…ORS DSM IV'de somatik sanr›lar içinde yer al›r 35 . Duygudurum bozukluklar›na ya da OKB'ye efllik edebilece¤i gibi monosemptomatik hipokondriak psikoz olarak ta görülebilir [36][37][38][39] . Hastalar bedenlerinin çok kötü koktu¤unu çevredeki insanlar›n bundan rahats›z oldu¤unu düflünürler, kokunun gitmesi amac›yla s›k s›k banyo yaparlar, s›k k›yafet de¤ifltirirler.…”

Section: Beden Ve A¤›z Kokusu Sanr›lar›unclassified

“…Baz›lar› kokular›n› örtmek için afl›r› parfüm kullan›rlar. Günde 2-3 kez çorap de¤ifltirerek önlem almaya çal›-fl›rlar 37,38,40 . OrS belirtileri hastalar aras›nda farkl›l›k gösterebilir.…”

Section: Beden Ve A¤›z Kokusu Sanr›lar›unclassified

Primer Psikiyatrik Hastalıklar

Mercan¹

2012

Turkderm

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“…This condition occurs in apparently healthy individuals who complain of chronic bad breath that no one else can smell and for which no local or systemic disease causing oral malodour could be found 1 . These patients believe that their breath is offensive even when no objective evidence of breath malodour can be identified [2][3][4][5][6][7] . Although several studies have been carried out on the aetiology, diagnosis and treatment of halitosis, physicians and dentists are generally poorly informed on the causes and treatment of halitosis [8][9][10][11][12][13] , specially in cases of delusional halitosis.…”

Section: Introductionmentioning

confidence: 99%