Olfactory Reference Syndrome Research Articles

Sufferers from olfactory reference disorder: lonely, depressed and socially pained?

Although the few studies available on Olfactory Reference Disorder (ORD) indicate that the disorder is associated with fear of rejection, avoidance and impairment of social relationships, there are no investigations that have examined loneliness and social pain in individuals with ORD. Additionally, despite studies showing elevated comorbidity of ORD and Major Depressive Disorder (MDD), the relationship between ORD according to the ICD-11 and depressiveness has not been investigated. This exploratory pilot study examined the association of symptoms of ORD according to the ICD-11 with emotional/social loneliness, social pain and depressiveness. A total of 225 German university/college students participated in an anonymous internet-based survey. Severity of ORD symptoms were significantly associated with more severe depressiveness, greater emotional and social loneliness as well as greater social pain. In our sample, participants with self-reported ORD reported on average elevated levels of social pain and loneliness. A total of 93.3% of the participants with self-reported ORD had elevated scores of depressiveness. Emotional and social loneliness remained significantly correlated with ORD symptoms in partial correlations that adjusted for depressive symptoms. In a multiple regression analysis, olfactory concerns were associated with the total loneliness score independent of the effects of depressiveness and social pain. These preliminary results highlight the importance of considering depressive symptoms and social pain in the assessment and treatment of ORD. In addition, results suggest that individuals suffering from ORD might be at increased risk for loneliness.

Associations between olfactory reference disorder and social phobia - results of an internet-based study.

Despite the similar clinical features of Olfactory Reference Disorder (ORD) and Social Phobia (SP), or studies showing elevated comorbidity of the two disorders, and the conceptualization of ORD as a form of SP in the East Asian culture, to our knowledge, the relationship between ORD and SP has not been investigated. This study examined the association of ORD according to the 11th revision of the International Classification of Diseases (ICD-11) and SP in 225 German university / college students who completed self-ratings with regard to socio-demographic data and symptoms of SP and ORD within an anonymous internet-based survey. Symptoms of SP were assessed with the Social Phobia Inventory (SPIN). Symptoms of ORD according to the ICD-11 were assessed with the Olfactory Reference Disorder Questionnaire (ORDQ), developed for this study. In our sample, 86.6% of the participants who met the self-rated features for ORD also met the self-rated criteria for current SP. ORD severity scores were significantly related to SP. Participants with and without self-reported ORD differed significantly in their SP total scores. SP severity was also significantly correlated with poorer insight of ORD-related beliefs, greater ORD-related avoidance of intimate relationships and higher levels of shame and fear of rejection due to body odor. These preliminary findings indicate that ORD could be closely related to SP and highlight the need for future research on the relationship of ORD and SP in order to gain a better understanding of the development, maintenance, treatment and classification of ORD.

Unravelling the Psychological Impact of Trimethylaminuria: Insights into the Management Strategies

Trimethylaminuria (TMAU), colloquially known as fish odour syndrome, is a rare metabolic disorder characterised by the body’s inability to properly metabolise Trimethylamine (TMA), resulting in a distinctive and unpleasant fishy odour in bodily secretions. This comprehensive review explores the pathophysiology, clinical manifestations, genetic basis, diagnostic challenges, and psychological impact of TMAU, along with management strategies. Genetic mutations affecting the flavin-containing monooxygenase 3 (FMO3) enzyme, which is responsible for TMA metabolism, contribute to the condition’s hereditary nature. Diagnosis can be challenging due to intermittent symptoms and overlaps with other conditions, such as Olfactory Reference Syndrome (ORS). The psychosocial impact of TMAU can be profound, leading to embarrassment, social isolation, and mental health issues. Management strategies include dietary modifications, supplements, antibiotics, and hygiene measures to alleviate symptoms. Despite advances in understanding TMAU, further research is needed to enhance diagnostic accuracy and therapeutic approaches, ultimately improving the quality of life for affected individuals.

Shared or Induced Olfactory Reference Syndrome.

Shared or Induced Olfactory Reference Syndrome.

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

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.

Olfactory Reference Syndrome: Its Relationship to Comorbidity of Social Anxiety Disorder and Obsessive-Compulsive Disorder.

Olfactory reference syndrome (ORS) is known to have the clinical features of both obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD). However, there has been no clear explanation as to why ORS has the characteristics of two different disorders. In the present study, the comorbidity rates of ORS in patients with SAD (without OCD, n = 83), ORS in patients with OCD (without SAD, n = 42), and patients with SAD and OCD comorbidity (n = 17) were compared. Of all 142 patients studied, 11 were diagnosed with ORS. The comorbidity rate of ORS in comorbid SAD/OCD group was significantly higher than those in both SAD and OCD groups. Logistic regression analysis of 100 cases of SAD and selected 69 cases of generalized SAD showed that the risk of ORS was significantly higher in patients with OCD and bulimia nervosa. Of 59 cases with OCD, the risk of ORS was significantly higher in patients with SAD. The results of the present study suggest that the comorbidity of SAD and OCD most likely explains the development of ORS.

"Jikoshu": Japanese studies in the 1960s and 1970s, and international trends today.

In the 1960s and 1970s, there was widespread discussion in Japan about the pathological experience of "unpleasant odors emanating from one's body." This symptom is called "Jikoshu," and this term was used in combination with various words, such as "Genkaku" (hallucination) and "Moso" (delusion), reflecting its symptomatological ambiguity. The best-known term in the English-language literature is Jikoshu-Kyofu (Jikoshu phobia). By further abstracting this symptom and viewing it as a delusion-like experience of "something leaking out of me," egorrhea syndrome (Fujinawa) was proposed, which was considered to be partly a pathology of schizophrenia. Similar cases were characteristically observed during adolescence, and a study emerged suggesting that the syndrome was "adolescent paranoia" (Murakami), distinct from schizophrenia. However, the terms "Jikoshu-Taiken" (Jikoshu experience; Kasahara et al.) and "Jikoshu-Sho" (Jikoshu syndrome; Miyamoto) were proposed to emphasize the nosological ambiguity. Considered a culture-bound syndrome unique to Japan or East Asia, Jikoshu received little attention in the English-language literature apart from a 1971 study of olfactory reference syndrome (Pryse-Phillips), which presents with similar symptoms. In recent years, research has placed this disorder within the obsessive-compulsive spectrum, and it has been adopted as an ICD-11 disorder under the term "olfactory reference disorder."

Olfactory Obsessions: A Study of Prevalence and Phenomenology in the Course of Obsessive-Compulsive Disorder.

Olfactory obsessions (OOs) are rarely described in the medical literature. The features of OOs appear consistent with characteristics of a typical obsession, but since they do not involve the realm of thought, it is questionable to term them obsessions per se. Olfactory Reference Syndrome (ORS) presents OOs inconsistently and is a distinctive diagnostic category related to OCD. Therefore, the primary objectives of our study were not only to assess the prevalence of OOs in OCD patients, but also to demonstrate their phenomenological consistency with other OCD symptoms. The study group consisted of 75 patients already diagnosed and treated for OCD. Hence, a comparison was made between OCD patients with and without OOs in terms of: symptom severity, level of insight and comorbidities. Olfactory obsessions (OOs) were found in 21.33% (n = 16). OOs induced compulsive behavior in more than 93% of subjects. The presence of OOs did not significantly differentiate the studied groups in terms of OCD severity (p = 0.876), level of insight (p = 0.680), depression (p = 0.746), mania (p = 0.525) and OCDP traits (p = 0.624). However, a comparison of the two groups showed that OOs patients presented higher levels of hostility (p = 0.036), cognitive impulsivity (p = 0.039), magic-type obsession (75% vs. 35.59%), and contamination obsession (87.50% vs. 67.80%). Conclusions: OOs frequently occur in the course of OCD, and their phenomenology is typical of this disorder. OOs are not a symptom of thought content disorders and are sensory in nature, which is not included in the definition of obsession. The presence of OOs in OCD provokes hostility and cognitive impulsivity. It can be assumed that the Olfactory Obsessions Questionnaire accurately identifies olfactory obsessions.

A Novel Perspective on Olfactory Reference Syndrome and Associated Specified Obsessive-Compulsive Disorders

A Novel Perspective on Olfactory Reference Syndrome and Associated Specified Obsessive-Compulsive Disorders

Tactics of Application of Cognitive Behavioral Therapy in the Treatment of Distorted Perception of Smell or Olfactory Reference Syndrome

Tactics of Application of Cognitive Behavioral Therapy in the Treatment of Distorted Perception of Smell or Olfactory Reference Syndrome

Obsessive-compulsive and related disorders according to ICD-11 and DSM-5 : With brief consideration of the new obsessive-compulsive disorders olfactory reference disorder and hypochondriasis

This article summarizes the current state of research with respect to the new obsessive-compulsive and related disorders (OCRD) grouping according to the International Statistical Classification of Diseases and Related Health Problems (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The ICD-11 grouping of OCRD is based on common clinical features, such as repetitive undesired thoughts and repetitive behavior and is supported by the literature and empirical data from the fields of imaging and genetics. The disorders in this grouping in ICD-11 include obsessive-compulsive disorder, pathological hoarding, body dysmorphic disorder, trichotillomania, excoriation disorder, and as new disorders differing to DSM‑5, hypochondriasis, olfactory reference disorder and Tourette syndrome. The aim of the OCRD grouping is an improvement of the diagnostics and appropriate treatment strategies as well as a further stimulation of research. The new disorders olfactory reference disorder and hypochondriasis are presented and discussed.

Two Cases of Olfactory Reference Syndrome Treated with Risperidone

Two Cases of Olfactory Reference Syndrome Treated with Risperidone

Olfactory reference syndrome: A case report

Olfactory reference syndrome: A case report

Management of Psychiatric Disorders with HIV and Dermatological Disorders.

Management of Psychiatric Disorders with HIV and Dermatological Disorders.

Is there a perceptual basis to Olfactory reference disorder?

Theoretical backgroundIndividuals with Olfactory Reference Disorder (ORD) share the belief that they spread an intense body odor which is offensive to others, even if objectively, this odor is not or only slightly perceived by others. QuestionsDo individuals with ORD differ from individuals without ORD in their ability to identify their own body odor and their hedonic evaluation of their own and foreign body odors? Do individuals with ORD report more negative emotions in response to their own body odor? SampleThirty-eight persons with clinically significant ORD and 38 matched controls. MethodOdor samples (sweat) were collected from all participants and presented to them (blind) for an identification and evaluation task. Facial changes due to the odor presentation were video-recorded. ResultsNo significant differences between groups emerged in the identification rate for one’s own body odor or in facial expressions. Individuals with ORD evaluated their own body odor as more disgusting than did the control group, even though they were unable to explicitly identify it. DiscussionThe sensitivity to one's own and foreign body odors is not more pronounced in individuals with ORD than in individuals without this syndrome. The differences found in the hedonic ratings may indicate a more implicit, cognitive processing of odor stimuli in ORD.

Olfactory Reference Syndrome (Halitophobia) With Oral Cenesthopathy Treated With Low-Dose Aripiprazole: A Case Report

IntroductionOlfactory reference syndrome (ORS) (halitophobia) is the excessive fear of having bad breath without clinical findings supporting the patient's complaints. In this case report, a low dose of aripiprazole (ARP) successfully improved oral cenesthopathy and then improved ORS.Case PresentationA 44-year-old female patient complained of a sensation of astringent film sticking on her tongue. She was also very anxious about her bad breath at work.We prescribed 0.5 mg of ARP for her symptoms because she worried about potential drowsiness. One week later, the patient reported that the oral sensation had resolved 2 to 3 days after the mediation was administered. No obvious adverse effects were observed except temporary arousal during sleep. Three months after the initial visit, her symptoms worsened, partly because of her job change, so we increased the dose of ARP from 0.5 mg to 1 mg. Later, the patient reported that she was better able to manage the anxiety about her breath. At the 2-year follow-up, her symptoms have continued to improve without medication.ConclusionsAlthough the most effective approach to ORS is not established, the current study indicates that a low dose of ARP to treat oral cenesthopathy might improve ORS.

Vortioxetine improved olfactory reference syndrome in a patient with major depressive disorder: A case report

Vortioxetine improved olfactory reference syndrome in a patient with major depressive disorder: A case report

Olfactory Reference Syndrome: a case report

Olfactory Reference Syndrome: a case report

Board Approves Action Items on Maintenance of Certification

Board Approves Action Items on Maintenance of Certification

P.774 Olfactory reference syndrome as a prodrome of Alzheimer disease

Osteoarthritis is a degenerative disease of the joint, affecting over 30 million people in the US1. A key characteristic of OA is chondrocyte hypertrophy, characterized by chondrocyte changes to a more rounded and osteoblastic phenotype, characterized by increased IL-6 and IL-8 secretion2. While there are no cures for OA, treatments focus on mitigating pain and inflammation, the two main symptoms of OA. However, the analgesics, NSAIDS and corticosteroids commonly used, do not target regeneration and have negative side effects. Local anesthetics (LA) can be used as a pain management alternative but are usually short lasting and therefore, not suited for chronic conditions such as OA. Our engineered sustained release local anesthetic construct successfully delivers bupivacaine for an extended period of time3-5. This study is designed to evaluate the effect of the LA system on chondrocytes in an inflammatory OA-like environment.Chondrocytes were cultured with bolus, liposomal, or construct LA and either untreated or treated with TNF-α and IL-1α for 24 hrs, 48 hrs, or 96 hrs. Chondrocyte viability, interleukin-8 (IL-8), interleukin-6 (IL-6), collagenase activity and proteoglycan deposition were assessed.In the presence of the engineered construct, the chondrocytes retained viability and regenerative function. Moreover, the construct allowed for higher initial doses to be used, which promoted more regeneration and decreased inflammation without compromising cellular viability.The construct promotes a less hypertrophic chondrocyte environment while promoting a more anti-inflammatory environment. These two factors are consistent with a less OA progressive environment when using the engineered construct, compared to bolus LA.