Olfactory Reference Syndrome paper published in pubmed

The paper about Olfactory Reference Syndrome recently mentioned in the blog has now been published on Pubmed :

Abstract
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.

Olfactory reference syndrome: issues for DSM-V

The outcome seems to be that they recommend including ORS to the Psychiatrist Manual of Mental Disorders. At the moment trimethylaminuria is the only generally accepted form of systemic body odor, so hopefully the psychiatrists will do their duty to their patients and arrange for the TMAU test at least, to any patient they wish to class as a case of ORS. There are likely a few more systemic body odors yet to be discovered, with dimethylglycinuria being an example of how they can find enzyme-related odors if they are really looking (perhaps only one person has ever being diagnosed as having this, perhaps because many very rare enzyme-related odors will exist ... as well as more common ones).

Ironically ORS being recognized as a mental disorder may unintentionally lead to more awareness of systemic body odors/halitosis and lead to research in that area.

María de la Torre
President and Chief Executive Officer

www.meboresearch.org
maria.delatorre@meboresearch.org

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UPDATE, 07 JANUARY 2011: See post, 'Exciting changes in Mental Health Field re Olfactory Reference Syndrome' Our efforts bore great success for our community, and now we need to disperse this new information amongst all mental health therapists as we continue with our Raising Awareness Campaign.

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