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Olfactory reference syndrome (ORS) is a distressing condition where people falsely believe they emit a foul odor.

What is Olfactory Reference Syndrome?

Olfactory reference syndrome (ORS), also known as olfactory reference disorder, is a lesser-known but often severe psychiatric condition. It bears similarities to obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD). Those with ORS mistakenly believe they emit a foul odor, although no such smell exists. This discrepancy between their perception and that of others leads to significant emotional distress and impairment in daily functioning.

Symptoms of ORS

People with ORS exhibit a range of symptoms, primarily revolving around their preoccupation with a perceived body odor. Common symptoms include:

Self-Smelling

Those afflicted frequently sniff themselves to check for odors.

Excessive Showering

They may bathe excessively to eliminate the supposed odor.

Changing Clothes

They often change clothes frequently, believing their garments retain the odor.

Seeking Reassurance

They repeatedly ask others if they smell bad.

Unusual Dietary Habits

Some alter their diets to reduce perceived flatulence.

Frequent Teeth Brushing

To combat perceived bad breath, they brush their teeth excessively.

Laundering Clothes

Clothes are washed frequently to remove the imagined odor.

Comparing Odors

They compare their supposed body odor to that of others.

Other symptoms include using perfumes or deodorants excessively, experiencing shame and embarrassment, and avoiding social situations due to fear of emitting a bad smell. These people often suffer from low self-esteem, anxiety, depression, and, in severe cases, suicidal thoughts and behaviors.

Treatment for ORS

Treatment for ORS has not been extensively studied, but effective methods are often similar to those used for OCD and BDD. The main treatments include:

Medications

Serotonin reuptake inhibitors (SRIs), such as fluoxetine, sertraline, and escitalopram, are commonly prescribed. These medications help reduce obsessive thoughts and compulsive behaviors, as well as alleviate associated depression and anxiety.

Cognitive-Behavioral Therapy (CBT)

This therapy aims to modify problematic thoughts and behaviors. It helps people develop accurate and helpful beliefs about their body odor, manage compulsive behaviors, and improve social interactions. CBT techniques used for BDD can be adapted for ORS with minor modifications.

While some patients benefit from either medication or therapy alone, a combination of both treatments is often recommended for severe cases. Seeking treatment from mental health professionals is crucial, as non-mental health interventions, like surgeries or consultations with ENT doctors, have not proven effective for ORS. With appropriate treatment, people with ORS can experience significant relief from their symptoms and improve their quality of life.