Treatment utilization and barriers to treatment among individuals with olfactory reference syndrome (ORS)

J Psychosom Res. 2018 Feb:105:31-36. doi: 10.1016/j.jpsychores.2017.12.004. Epub 2017 Dec 5.


Objective: Olfactory reference syndrome (ORS) is characterized by a preoccupation that one is emitting a foul or offensive odor. Despite the profound psychosocial impact of ORS, many patients do not receive appropriate treatment, and there is no empirical research on treatment-seeking behavior in ORS. This study investigated treatment utilization patterns and barriers to treatment in individuals with ORS.

Method: 253 subjects completed an online survey between January-March 2010. Data were obtained from the Yale-Brown Obsessive Compulsive Scale Modified for ORS (ORS-YBOCS), Depression Anxiety Stress Scales (DASS), Work and Social Adjustment Scale (WSAS), and questionnaires specific to treatment utilization and barriers.

Results: The sample was ethnically diverse, predominately male (67%), with an average age of 33.7years, and moderately severe ORS symptoms. Most participants first sought care from a medical specialist (44%), and mental health services were underutilized (14%). Higher functional impairment was significantly correlated with seeking care from a mental health provider, compared to a medical specialist. Nearly all participants endorsed multiple barriers to treatment, including (a) logistical/financial, (b) stigma/discrimination, and (c) treatment perception barriers. ORS symptom severity was significantly, positively correlated with number of logistical/financial and stigma/discrimination barriers. Treatment barriers were significantly influenced by ethnic group, ORS symptom severity, and source of odor.

Conclusion: Results highlight the importance of increasing awareness and enhancing access to care for individuals with ORS.

Keywords: Jikoshu-kyofu; Malodour; Obsessive compulsive disorder; Olfactory reference syndrome; Tajin kyofusho; Treatment.

MeSH terms

  • Adult
  • Body Dysmorphic Disorders / psychology
  • Body Dysmorphic Disorders / therapy*
  • Body Image
  • Female
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Odorants
  • Olfaction Disorders / psychology
  • Olfaction Disorders / therapy*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Surveys and Questionnaires
  • Syndrome