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Mental Health Center

Many Delusional About Smelling Bad

Researchers Say Olfactory Reference Syndrome Is Vastly Under-Recognized
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WebMD Health News
Reviewed by Laura J. Martin, MD

May 25, 2010 (New Orleans) -- Researchers say a psychiatric condition characterized by a person's mistaken belief that he or she smells bad is vastly under-recognized.

Called olfactory reference syndrome, the condition is "probably very common," says Katharine Phillips, MD, of Rhode Island Hospital in Providence.

"These patients suffer tremendously,” she tells WebMD. "They are preoccupied with the belief that they are emitting a foul or offensive body odor, which is not perceived by others."

"They’re impaired in terms of functioning and they have high rates of suicidality," Phillips says.

At a news briefing at the American Psychiatric Association meeting, Phillips said the condition has been described around the world for more than a century but has only been minimally studied.

So she and colleagues examined the features of olfactory reference syndrome in 20 patients seen at a Providence, R.I. hospital.

Their average age was 33, and 60% were female. Their symptoms started between ages 15 and 16, on average.

Many Hours Spent Preoccupied With Smelling Bad

Overall, patients spent three to eight hours a day preoccupied with their concerns that they smelled bad.

"They had thoughts such as "I smell horrid' or "People are moving because I stink,'" Phillips says.

A total of 85% were completely convinced that that they emitted a foul odor, even though they didn't.

About three-fourths thought others took special notice of them, misinterpreting benign acts like scratching their nose or wanting to open a window because a room is stuffy, she says.

Also, 44% sought non-psychiatric treatment for their perceived body odor, including visits to gastroenterologists, dentists, and dermatologists.

"Usually, those treatments didn’t diminish their worry about body odor," Phillips says.

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