In olfactory reference disorder (often called olfactory reference syndrome), people are preoccupied with the belief that they give off an unpleasant, foul-smelling, or offensive body odor when in fact they do not.
People with olfactory reference disorder believe that they have an offensive body odor even though they do not. This belief causes them significant distress and usually makes them less able to function—for example, by preventing them from going out in public. Olfactory reference disorder has similarities with body dysmorphic disorder and is classified as an obsessive-compulsive and related disorder.
Usually, people with olfactory reference disorder repeatedly do certain things, such as showering excessively, brushing their teeth, or checking themselves for body odor (for example, by smelling themselves), in response to this preoccupation. These people often use excessive perfume, deodorant, or mouthwash to try to cover up the odor that they think they have. They may also think that others are sitting far away, covering their noses, or taking special notice of them in a negative way because of the perceived odor.
Treatment with a selective serotonin reuptake inhibitor or clomipramine (types of antidepressant) may help. An atypical neuroleptic (atypical antipsychotic) is sometimes added to one of these medications.
Cognitive-behavioral therapy similar to that used for body dysmorphic disorder may be helpful.
