Stinking Thinking: Olfactory Hallucinations Wreak Havoc for People with Mysterious Delusional Disorder

Olfactory reference syndrome (ORS) is a mysterious delusional disorder causing olfactory hallucinations that lead sufferers to imagine that they have offensive body odor. This mysterious delusional disorder is a chronic condition that can wreak havoc in the lives of those who suffer from it, ruining careers and relationships and posing a risk of suicide.

Imaginings of Offensive Body Odors Vary

Offensive body odors may be imagined to originate in the intestinal tract, the mouth, the genitalia, or any other part of the body. Patients may be concerned with odor from only one body part or from many body parts simultaneously. They may perceive only one, or multiple, offensive body odors. Imagined offensive body odors may be that of feces or urine or of smells not commonly associated with the body such as ammonia or sulfur.

Olfactory Hallucinations Affect Relationships and Careers

ORS patients suffer shame and embarrassment due to a belief that others are talking about their offensive body odor. They commonly misinterpret the actions of others in a way that intensifies belief in the validity of olfactory hallucinations. For example, a coworker's opening of a window or use of a favorite room deodorizer may be interpreted as an avoidance of the offensive body odor.

Attempts of people with ORS to remedy offensive body odors (such as dowsing themselves in perfume) may repulse others, further isolating ORS sufferers and reinforcing their beliefs that they stink.

Even with reassurance from others that there is no foul odor, ORS patients often leave their jobs because of fears that others find them objectionable. They break dates, avoid travel, avoid sexual intimacy, and sometimes become housebound. They may even move to another town because of embarrassment over imagined offensive body odor.

Obsessive-Compulsive Behavior

People with ORS engage in multiple obsessive-compulsive behaviors. They constantly check themselves for offensive body odor. There may be obsessive cleaning of body parts, changing clothes, washing clothes, or heavy application of perfume, deodorant, mouthwash or other types of smell camouflage. These time-consuming activities can negatively affect performance on the job or at school.

ORS patients constantly seek reassurance from others about the way they smell and they spend a lot of time checking themselves for offensive body odors.

Treatment for ORS

Convincing ORS sufferers that they are having olfactory hallucinations is difficult. They obsessively seek medical treatment from practitioners such as dentists, gastroenterologists, and proctologists. In spite of negative medical findings, some take part in unnecessary surgeries in desperate attempts to correct their perceived offensive body odors.

Treatment of co-morbid conditions such as depression does not guarantee improvement of ORS and many patients have no other mental health symptoms.

No conclusive studies have been done that clearly point to a universally effective treatment. Treatment with antidepressant or antipsychotic medications, or a combination of them, yields variable results. Long-term cognitive therapy, over months or years, is sometimes helpful.

Summary

ORS is a mental health condition involving olfactory hallucinations that cause sufferers to imagine that they give off an offensive body odor. ORS can wreak havoc in the lives of those who suffer from it, sometimes causing suicide. Unfortunately, research done so far has not elucidated the exact cause of, nor found universally effective treatment for, ORS.

Sources:

No author given. Rare Disorder Has People Convinced They Smell Bad. Medline Plus.

C. Lochner and D. J. Stein. Olfactory Reference Syndrome: Diagnostic Criteria and Differential Diagnosis. Journal of Postgraduate Medicine, Seth GS Medical College and KEM Hospital.

Katharine A. Phillips and David J. Castle. How to Help Patients with Olfactory Reference Syndrome. Delusion of Body odor Causes Shame, Social Isolation. The Journal of Family Practice.