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Olfactory Reference Disorder: Diagnosis, Epidemiology and Management

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Abstract

Although not included as a disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), olfactory reference disorder (ORD) is being considered for inclusion as a discrete disorder in the ICD-11 (International Classification of Diseases, 11th edition). ORD is likely underdiagnosed and undertreated. The purpose of this paper is to provide information to clinicians and researchers on the epidemiology, clinical presentation and treatment options for this condition. A narrative overview of the literature as retrieved from a computerized database search is provided. ORD is a condition that is characterized by the erroneous belief that one emits a foul or unpleasant body odour, resulting in significant distress and impairment. It is often accompanied by referential thinking and repetitive behaviours aimed at camouflaging the perceived odour. Level of insight varies, with some patients having concerns that are delusional. Patients usually do not spontaneously report their symptoms and so screening in suspected cases is crucial. The literature regarding ORD treatment remains limited.

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Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg, Cape Town, 7505, Western Cape, South Africa

    Eileen Thomas, Stéfan du Plessis & Bonginkosi Chiliza

  2. US/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa

    Christine Lochner & Dan Stein

  3. US/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Western Cape, South Africa

    Dan Stein

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  1. Eileen Thomas
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  3. Bonginkosi Chiliza
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  4. Christine Lochner
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  5. Dan Stein
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Corresponding author

Correspondence to Eileen Thomas.

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Conflicts of interest

Prof. D. J. Stein is supported by the Medical Research Council of South Africa and has received research grants and/or consultancy honoraria from Abbot, AstraZeneca, Eli Lilly, GlaxoSmithKline, Jazz Pharmaceuticals, Johnson & Johnson, Lundbeck, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo, Takeda, Tikvah, and Wyeth.

Dr. B. Chiliza has received honoraria from Janssen, Lundbeck and Sandoz for speaking at educational meetings.

Dr S. du Plessis is supported by the Medical Research Council of South Africa.

Prof. C. Lochner is supported in her work by a grant from the Medical Research Council of South Africa. She has also received funding from the National Research Foundation of South Africa and the Harry & Doris Crossley Foundation.

Dr. E. Thomas has no conflicts of interest to declare.

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The authors received no funding towards the preparation of this manuscript.

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Thomas, E., du Plessis, S., Chiliza, B. et al. Olfactory Reference Disorder: Diagnosis, Epidemiology and Management. CNS Drugs 29, 999–1007 (2015). https://doi.org/10.1007/s40263-015-0292-5

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