Olfactory reference disorder—a review

IF 1.5 Q3 PSYCHIATRY Middle East Current Psychiatry Pub Date : 2023-12-04 DOI:10.1186/s43045-023-00367-5
Savitha Soman, Rajesh Nair
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Abstract

Olfactory Reference Disorder (ORD) is a known clinical entity for several decades; however, it is only in ICD 11 that it has found its niche. Long considered a delusional disorder, it is currently classified as an obsessive–compulsive (OC) spectrum disorder. ORD is characterised by an erroneous conviction that the body is emitting an unpleasant smell. Patients harbour referential thinking, practise rituals to eliminate or mask the perceived odour, and avoid social interactions. While the conviction can be at a delusional level in some patients, the preoccupation has an obsessive quality in others. The level of insight can be varied. Patients present to mental health settings after traversing a long pathway of care comprising of various specialists. Medical and psychiatric conditions which can present with ORD-like symptoms need to be ruled out. Establishing a therapeutic alliance is the first step in management. There are no randomised controlled trials comparing treatment options in ORD. Antidepressants, antipsychotics, and their combinations have been used with varying degrees of success, in addition to psychotherapy and electroconvulsive therapy. Data on prognosis is limited.
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嗅觉参照障碍综述
嗅觉参考障碍(ORD)是几十年来已知的临床实体;然而,只有在ICD 11中,它才找到了自己的位置。长期以来被认为是一种妄想障碍,目前被归类为强迫症(OC)谱系障碍。ORD的特点是错误地认为身体散发出难闻的气味。患者怀有参照思维,通过仪式来消除或掩盖感知到的气味,并避免社交互动。虽然这种信念在一些病人身上可能达到妄想的程度,但在另一些病人身上,这种专注有一种强迫症的性质。洞察力的水平可以是不同的。患者在经历了由不同专家组成的漫长的护理途径后,来到精神卫生机构。需要排除可能出现类似ord症状的医学和精神疾病。建立治疗联盟是治疗的第一步。目前还没有比较强迫症治疗方案的随机对照试验。除了心理治疗和电休克治疗外,抗抑郁药、抗精神病药及其联合使用也取得了不同程度的成功。预后数据有限。
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来源期刊
Middle East Current Psychiatry
Middle East Current Psychiatry Medicine-Psychiatry and Mental Health
CiteScore
3.00
自引率
0.00%
发文量
89
审稿时长
9 weeks
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