The Signs of Olfactory Reference Syndrome

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Olfactory Reference Syndrome: Introduction

Most people have at least some concern about how they smell. The body care industry floods the market with a dizzying array of products such as deodorants, perfumes, soaps, body washes and scrubs to keep us clean and smelling sweet. They cater and pander to our concern about not smelling bad, but there are some amongst us who take this anxiety about not offending others with body odor to an extreme – to the point where it becomes an obsession. These people may well have a condition called olfactory reference syndrome.

Offensive Odors

Olfactory reference syndrome is a psychiatric condition where a person becomes preoccupied with the idea that they have an unpleasant body odor and that other people can smell it and are offended by it. Their preoccupation may focus on the fear that they have an overall bad body odor, offensive breath, a bad smell coming from their genital area, smelly underarms, bad odors coming from their anal region – or any or all of the above. They may be convinced that virtually any part of their body has a very offensive smell.

Not surprisingly, people with olfactory reference syndrome will go to very great lengths to mask or hide their “bad odor” from others. This includes repetitive bathing or the excessive use of perfumes, deodorants and mouthwash. Some visit the doctor’s surgery in search of an answer as to why they smell and in extreme cases a minority of people have opted to have their tonsils removed to eliminate “bad breath”.

Reassurances that they don’t smell aren’t enough to comfort people with olfactory reference syndrome and they’ll go to great lengths not to sit close to anyone. They will also shield their face when talking to avoid offending people nearby with their perceived mouth odor. So sensitive are people with olfactory reference syndrome to exposing others to their smell that they avoid public situations. According to research by Malasi, El-Hiru and Mirza published in the British Journal of Psychiatry, this can lead to complete social isolation for people who don’t get help

How many people are affected by this condition? No one knows for sure. But olfactory reference syndrome is not a rare condition as it is estimated that anywhere from 0.5% to 2% of the population has some features of this disorder.

Why It’s Important for People with Olfactory Reference Syndrome to Get Help

According to the Journal of Family Practice, over 40% of people with olfactory reference syndrome contemplate suicide and more than 5% actually follow through and take their own life. This disorder will typically worsen over time if a person doesn’t seek professional medical help.

An accurate diagnosis is important since people with other psychiatric disorders such as depression and schizophrenia can have similar symptoms. Not surprisingly, many people who suffer with olfactory reference syndrome develop secondary symptoms of depression, which makes the condition even more challenging to treat.


The Journal of Family Practice. Volume 6, No. 3. March 2007.

Journal of Postgraduate Medicine. 49(4): 328-331.

Br J Psychiatry 1990;156:256–60. 1990;156:256–60.