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18 - Delusions of Body Malodour: The Olfactory Reference Syndrome

from Section III - Assessment and Disorders of Olfaction

Published online by Cambridge University Press:  17 August 2009

By
Katharine Phillips ,
Craig Gunderson ,
Uschi Gruber  and
David Castle
Edited by
Warrick J. Brewer ,
David Castle  and
Christos Pantelis
Foreword by
Peter Doherty
Warrick J. Brewer
Affiliation:
Mental Health Research Institute of Victoria, Melbourne
David Castle
Affiliation:
University of Melbourne
Christos Pantelis
Affiliation:
University of Melbourne
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Summary

He said: ‘For the past three months I've been giving off a body odor. It smells like a swamp, dug up mud, a rotten smell; it comes from my guts. I can't go anywhere. I don't want to go with my friends, and I think I've lost them on account of that …. I smell it through my nose. I smell it all over the body. I think it stays 6 feet around me. It smells more in front of me. Sometimes it smells like a swamp. I never experienced something similar….’

Gabriel Garcia Marquez

Introduction

The olfactory reference syndrome (ORS) is an under-recognised type of delusional disorder that has been described for more than a century. It consists of a false belief that one emits an offensive body odour and is often accompanied by prominent delusions of reference and repetitive behaviours aimed at checking or reducing the perceived odour. ORS is associated with significant distress and impaired functioning, especially in the social realm. Many patients seek nonpsychiatric treatment from gastroenterologists, dermatologists, proctologists, dentists and other specialists; however, such treatments appear to be generally ineffective. In contrast, although data are limited, certain psychotropic medications and behavioural interventions are promising.

This chapter discusses ORS's history, clinical features, prevalence, treatment response, possible pathogenesis, nosological status and relationship to other psychiatric disorders, including mood disorders, schizophrenia, social phobia, and obsessive compulsive disorder (OCD).

Keywords

antidepressantsantipsychoticsolfactory reference syndromeORSpsychiatric interventionspsychological treatments
Type
Chapter
Information
Olfaction and the Brain , pp. 334 - 354
Publisher: Cambridge University Press
Print publication year: 2006

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