The authors report they have no financial relationships within the past 3 years to disclose.
Olfactory reference syndrome: issues for DSM-V†
Article first published online: 28 APR 2010
© 2010 Wiley-Liss, Inc.
Depression and Anxiety
Volume 27, Issue 6, pages 592–599, June 2010
How to Cite
Feusner, J. D., Phillips, K. A. and Stein, D. J. (2010), Olfactory reference syndrome: issues for DSM-V. Depress. Anxiety, 27: 592–599. doi: 10.1002/da.20688
- Issue published online: 2 JUN 2010
- Article first published online: 28 APR 2010
- Manuscript Accepted: 16 FEB 2010
- Manuscript Revised: 15 FEB 2010
- Manuscript Received: 6 NOV 2009
- delusional disorder;
The published literature on olfactory reference syndrome (ORS) spans more than a century and provides consistent descriptions of its clinical features. The core symptom is preoccupation with the belief that one emits a foul or offensive body odor, which is not perceived by others. This syndrome is associated with substantial distress and disability. DSM-IV and ICD-10 do not explicitly mention ORS, but note convictions about emitting a foul body odor in their description of delusional disorder, somatic type. However, the fact that such symptoms can be nondelusional poses a diagnostic conundrum. Indeed, DSM-IV also mentions fears about the offensiveness of one's body odor in the social phobia text (as a symptom of taijin kyofusho). There also seems to be phenomenological overlap with body dysmorphic disorder, obsessive–compulsive disorder, and hypochondriasis. This article provides a focused review of the literature to address issues for DSM-V, including whether ORS should continue to be mentioned as an example of another disorder or should be included as a separate diagnosis. We present a number of options and preliminary recommendations for consideration for DSM-V. Because research is still very limited, it is unclear how ORS should best be classified. Nonetheless, classifying ORS as a type of delusional disorder seems problematic. Given this syndrome's consistent clinical description across cultures for more than a century, substantial morbidity and a small but growing research literature, we make the preliminary recommendation that ORS be included in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and we suggest diagnostic criteria. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc.