psychiatric disorders
Olfactory Reference Disorder
Key Points
Patients are preoccupied with emitting≥1 perceived body odors that are not apparent or appear only slight to other people. Patients respond to their body odor concerns by performing repetitive behaviors (eg, excessive showering, teeth brushing, clothes laundering) and/or attempting to camouflage the perceived odor (eg, with excessive perfume or deodorant use). Patients typically have poor or absent insight. Treat using cognitive-behavioral therapy similar to that for body dysmorphic disorder and/or pharmacologic therapy with an SSRI orclomipramine, plus an atypical antipsychotic if needed. 