DOI: 10.1192/j.eurpsy.2026.11802 ISSN: 0924-9338

A Rare but Debilitating Disorder: A Case Report On Olfactory Reference Syndrome

S. M. Alshahrani
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Introduction

Olfactory reference syndrome (ORS) is persistent and false belief that one emits a foul, unpleasant, or socially offensive body odor lead to anxiety, depression, and significant functional impairment. Diagnosis remains challenging as its overlap with multiple psychiatric conditions. Despite DSM-5 categorized it as a part of “other specified obsessive-compulsive and related disorders,” its classification remains debated.

Objectives

We aim to discus Olfactory reference syndrome (ORS) and its place in the DSM-5/ICD-11 diagnostic systems.

Methods

We present this case study of a 45-year-old male with persistent foul mouth odor, accompanied by significant anxiety and repetitive hygiene behaviors that impacted his social and occupational functioning. Upon admission, physical and neurological examinations are normal. Mental status examination with Yale-Brown Obsessive-Compulsive Scale reflecting severe obsessive-compulsive symptoms. Patient was started on Cognitive Behavioral Therapy (CBT), with multiple interruptions and restarts of various psychiatric medications. Currently, He is on Aripiprazole 5 mg/day, Fluoxetine 20 mg/day, and a gradual tapering of Olanzapine with CBT.

Results

Table 1.

Table 1. Long description.

Proposed calcification for olfactory reference syndrome
Primary olfactory reference syndrome
When the condition does not have significant cause nor comorbid condition or substance use; it can be called primary olfactory reference syndrome.
Comorbid olfactory reference syndrome
When the condition has significant cause or comorbid psychiatric or medical condition or substance use; it can be called comorbid olfactory reference syndrome. Comorbid psychiatric conditions include obsessive compulsive disorder, depression, and anxiety disorders. Other medical conditions include neurological disorders and substance abuse.

Conclusions

This case study supports the perspective that olfactory reference syndrome is related to other specified obsessive-compulsive and related disorders classification. Future research should seek to delineate Olfactory reference syndrome (ORS) placewithin psychiatric classification systems.

Disclosure of Interest

None Declared

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