Olfactory Reference Syndrome (ORS) is a little-known psychiatric condition that profoundly affects those who suffer from it. Patients with ORS are plagued by the unfounded belief that they emit a terrible body odor. This overwhelming preoccupation leads to anxiety, embarrassment, and severe distress. Individuals with the condition often resort to excessive hygiene practices in a futile attempt to dispel the imaginary odor. When these efforts fail, they may withdraw socially, leading to avoidant behavior.
Symptoms of ORS typically manifest in a person's 20s, making early diagnosis challenging, as patients are often convinced the odor is real. The difficulty in diagnosing ORS lies in this firm belief, which leads sufferers to consult numerous specialists, such as dentists and dermatologists, seeking solutions to an odor that does not exist.
“People with ORS have often gone from doctor to doctor before being referred to psychiatry,” – Masse
In Morganne Masse's study, two patients presented severe cases of ORS. One was a 53-year-old man who had completely withdrawn from social life due to the condition. The other was a 63-year-old man who had battled ORS since his 20s. These cases underscore the profound impact of ORS on individuals' lives and highlight the importance of recognizing and addressing the syndrome.
“They will consult numerous specialists — dentists, dermatologists — to try to eliminate the odors they believe they emit.” – Masse
Treatment for ORS involves addressing both the obsessive concerns and the delusional component of the condition. Certain antidepressants have shown promise in alleviating symptoms by reducing obsessive thoughts. Additionally, Cognitive Behavioral Therapy (CBT) has been effective in diminishing dysfunctional thoughts and anxiety and is often recommended alongside antidepressants.
“CBT has been shown to reduce dysfunctional thoughts and anxiety, while antidepressants are also recommended, often in combination with CBT,” – Masse
For those with a deeply entrenched belief in their perceived odor, addressing the delusional aspect of ORS is crucial. This approach is similar to treating the positive symptoms of psychosis. While isolated case studies suggest potential benefits of combining antidepressants and antipsychotics, the latter are generally less effective.
“Another approach is to address the delusional component of ORS similarly to the way we treat the positive symptoms of psychosis. Isolated case studies suggest the efficacy of combining antidepressants and antipsychotics, although the latter are generally less effective.” – Masse
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