Prevalence of olfactory reference disorder according to the ICD-11 in a German university student sample

Abstract

Olfactory reference disorder (ORD) is included as a new diagnosis in the 11th revision of the International Classification of Diseases (ICD-11). Its core symptom is persistent preoccupation with the belief that one is emitting a foul or offensive body odor or breath that is usually not perceptible to others. However, there is a lack of knowledge about the prevalence of ORD. In particular, the prevalence of the disorder has not yet been investigated using the ICD-11 diagnostic features. Therefore, this study aimed to assess the point prevalence of ORD according to the ICD-11. A total of 275 German students at university or college, aged 18–53 years, participated in an anonymous internet-based survey assessing ICD-11 essential features for ORD. The prevalence of ORD was 5.5%. Participants who met the self-rated features for ORD reported suicidal thoughts significantly more frequent than participants who did not meet the features for ORD. More than half of the participants with probable ORD reported ideas of reference and at least a strong conviction of their beliefs, suggesting poor insight. In the total sample, single symptoms of ORD were frequent. Persistent preoccupation with the belief of malodor was the most common single symptom. Distress and impairment linked to ORD symptoms were frequent. Our results suggest that ORD may be relatively common in university students and highlight the importance of future studies investigating the epidemiology of ORD as well as its suitable treatment.