Magazine article Clinical Psychiatry News

Small Study Highlights Olfactory Reference Syndrome

Magazine article Clinical Psychiatry News

Small Study Highlights Olfactory Reference Syndrome

Article excerpt

Patients with olfactory reference syndrome have high rates of clinical depression and other comorbid psychiatric disorders, and nearly half of them do not seek psychiatric treatment for their perceived order.

Those are key findings from a small, novel study discussed during a press briefing sponsored by the American Psychiatric Association.

Olfactory reference syndrome (ORS) is a preoccupation with the belief that one emits a foul or offensive body odor that is not perceived by other people, said lead study investigator Dr. Katharine A. Phillips, of the department of psychiatry at Rhode Island Hospital/Brown University, Providence.

The few reports about ORS that have been published in the last century "suggest that it is clinically important," she said. "Patients suffer tremendously as a result of this false belief, and they appear to be very impaired in terms of their functioning and to have high rates of suicidality."

In an effort to better understand the clinical features of ORS, the researchers used semistructured measurement tools to assess 20 patients with the syndrome, including the Structured Clinical Interview for DSM-IV (SCID) to assess comorbidity, the Brown Assessment of Beliefs Scale to assess insight/delusionality and referential thinking, and a slightly modified version of the Yale-Brown Obsessive Compulsive Scale to assess ORS severity. The mean age of patients was 33 years, 60% were female, and the mean age of onset was 16 years.

Patients reported being preoccupied with their perceived body odor for 3-8 hours per day, mostly the mouth (75%), armpits (60%), and genitals (35%). Bad breath was the most common odor description reported (75%), followed by sweat (65%).

Most patients (85%) reported being completely convinced that their belief about the odor was accurate, and 77% reported thinking "that other people take special notice of them in a negative way because they smell so bad," Dr. Phillips said. In addition, 85% of patients reported that they actually smelled the odor (an olfactory hallucination).

All of the patients reported practicing repetitive behaviors in an effort to camouflage the perceived odor, mostly with perfume or scented powder (90%), chewing gum (60%), deodorant (55%), and mints (55%).

"Some patients actually drank perfume," she said. …

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