Olfactory Reference Syndrome – Symptoms and Treatment
Olfactory Reference Syndrome (ORS), also known as Autodysomophobia and Bromosis, is characterized by excessive, irrational fear that one is emitting a foul or unpleasant odor. The obsession may be an exaggerated, disproportionate concern with a natural body smell, or mayinvolve an entirely imagined odor. ORS goes beyond normal concern with one’s hygiene, and may significantly impair academic and professional functioning, as well as interpersonal relationships. In extreme cases, individuals with Olfactory Reference Syndrome may quit work and avoid social situations in an effort to avert the embarrassment they imagine they will experience when others detect the alleged odor.
Common Olfactory Reference Syndrome obsessions include:
- Exaggerated fear of having extremely bad breath (halitophobia)
- Thoughts of having a foul, noticeable anal odor
- Belief in having a foul, noticeable vaginal odor
- Fear of having a foul overall body odor
- Fear of having an unnatural, non-human or chemical odor
- Believing 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)
Common Olfactory Reference Syndrome compulsions include:
- Repetitive showering and other grooming behaviors
- Excessive use of deodorants, perfumes, and mouthwash
- Repeatedly checking the source of the alleged odor
- Seeking reassurance from others that there is no odor
- Avoidance of social situations for fear that others will notice the smell
- Multiple visits to doctors regarding the odor
As demonstrated above, Olfactory Reference Syndrome has obsessive-compulsive features that are quite similar to both OCD and BDD. In fact, ORS is considered by many to be a sub-type of OCD or BDD, and does not currently exist as a separate diagnostic category in the Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association. Regardless of the diagnostic terminology used, it is important to note that the cyclical process by which the symptoms in Olfactory Reference Syndrome intensify is the same as in OCD and BDD. In this process, called the Obsessive-Compulsive Cycle, the compulsive and avoidant behaviors that individuals employ in an effort to reduce their anxiety actually reinforce and worsen their obsessions. To learn more about this process, click here.
One of the most effective CBT developments for the treatment of Olfactory Reference Syndrome is Mindfulness-Based Cognitive-Behavioral Therapy. The primary goal of