Olfactory Reference Syndrome (ORS) (also referred to as Autodysomophobia) is a psychiatric condition in which the affected person is excessively preoccupied by the concern that one's body odor

Body odor

Body odor or body odour, sometimes colloquially abbreviated as B.O., is the smell of bacteria growing on the body. The bacteria multiply rapidly in the presence of sweat, but sweat itself is almost completely odorless to humans....

 is foul or unpleasant. This disorder is often accompanied by shame

Shame

Shame is, variously, an affect, emotion, cognition, state, or condition. The roots of the word shame are thought to derive from an older word meaning to cover; as such, covering oneself, literally or figuratively, is a natural expression of shame....

, embarrassment

Embarrassment

Embarrassment is an emotional state of intense discomfort with oneself, experienced upon having a socially unacceptable act or condition witnessed by or revealed to others. Usually some amount of loss of honour or dignity is involved, but how much and the type depends on the embarrassing situation...

, significant distress

Distress (medicine)

In medicine, distress is an aversive state in which an animal is unable to adapt completely to stressors and their resulting stress and shows maladaptive behaviors...

, avoidance behavior

Avoidant personality disorder

Avoidant personality disorder is a personality disorder recognized in the Diagnostic and Statistical Manual of Mental Disorders handbook in a person characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of...

, social phobia

Social anxiety disorder

Social anxiety disorder , also known as social phobia, is an anxiety disorder characterized by intense fear in social situations causing considerable distress and impaired ability to function in at least some parts of daily life...

 and social isolation

Social isolation

Social isolation refers to a lack of contact with society for members of social species. There may be many causes and individuals in numerous generally social species are isolated at times, it need not be a pathological condition. In human society, in those cases where it is viewed as a pathology,...

. ORS is not recognised by the Diagnostic and Statistical Manual of Mental Disorders

Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

, however it is considered by many to be a sub-type of Body dysmorphic disorder

Body dysmorphic disorder

Body Dysmorphic Disorder is a type of mental illness, a somatoform disorder, wherein the affected person is exclusively concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of his or her physical features...

. ORS links obsessive and compulsive aspects. Sufferers may have trouble concentrating at a given task or in particular situations due to obsessive thoughts concerning body odor.

Symptoms

Common symptoms of ORS include excessive thoughts of having:

• halitosis
  Halitosis
  Halitosis is a term used to describe noticeably unpleasant odors exhaled in breathing. Halitosis is estimated to be the third most frequent reason for seeking dental aid, following tooth decay and periodontal disease.- General :...
  
   (bad breath)
• anal odor
• vaginal odor
• overall body odor
• an unnatural, non-human or chemical odor

People with ORS believe others' behaviors or comments are related to the imagined odor (e.g., another's cough, sneeze, or turning of the head is due to the alleged odor).

Compulsive behaviors

Individuals with ORS often engage in time-consuming behaviors in an attempt to alleviate their perceived odor. Common compulsive behaviours include:

• Repetitive showering and other grooming
  Personal grooming
  Personal grooming is the art of cleaning, grooming, and maintaining parts of the body. It is a species-typical behavior that is controlled by neural circuits in the brain.- In humans :...
  
   behaviors.
• Excessive use of deodorant
  Deodorant
  Deodorants are substances applied to the body to affect body odor caused by bacterial growth and the smell associated with bacterial breakdown of perspiration in armpits, feet and other areas of the body. A subgroup of deodorants, antiperspirants, affect odor as well as prevent sweating by...
  
  s, perfume
  Perfume
  Perfume is a mixture of fragrant essential oils and/or aroma compounds, fixatives, and solvents used to give the human body, animals, objects, and living spaces "a pleasant scent"...
  
  s, and mouthwash
  Mouthwash
  Mouthwash or mouth rinse is a product used to enhance oral hygiene. Some manufacturers of mouthwash claim that antiseptic and anti-plaque mouth rinse kill the bacterial plaque causing cavities, gingivitis, and bad breath. Anti-cavity mouth rinse uses fluoride to protect against tooth decay...
  
  .
• Repeatedly scraping of the tongue
• Repeatedly checking the source of the alleged odor.
• Seeking reassurance from others that there is no odor.
• Avoidant personality
  Avoidant personality disorder
  Avoidant personality disorder is a personality disorder recognized in the Diagnostic and Statistical Manual of Mental Disorders handbook in a person characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of...
  
  : a fear that individuals detect foul odor when in social environments.
• Frequent visits to doctor regarding their perceived foul odor.
• Repeatedly accusing family members of emitting foul odors.
• Excessive use of scented candles.

Treatment

Olfactory reference syndrome may be treated with Cognitive Behavioral Therapy and/or selective serotonin reuptake inhibitor

Selective serotonin reuptake inhibitor

Selective serotonin re-uptake inhibitors or serotonin-specific reuptake inhibitor are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. The efficacy of SSRIs is disputed...

s.

External links

• http://dsm5.org/Research/Documents/Feusner_ORS.pdf - OLFACTORY REFERENCE SYNDROME: ISSUES FOR DSM-V
• Olfactory Reference Syndrome—OCD and Related Disorders Clinic and Research Unit at Massachusetts General Hospital
• Olfactory Reference Syndrome—Los Angeles Body Dysmorphic Disorder & Body Image Clinic
• Olfactory Reference Syndrome—OCD Center of Los Angeles