Introduction: The olfactory reference syndrome (ORS) is a condition characterized by the false belief that one emits a foul or offensive body odor. There is no consensus on the validity of this syndrome as an independent clinical entity.
Patients and methods: A systematic review of the literature is done (1966-2011) searching for articles about the ORS that included a case report using PsycINFO, PubMed, Medline and ISI Web of Knowledge. Data obtained from 55 cases were analyzed to evaluate clinical consistency and heuristic value of this syndrome.
Results: The clinical picture is: social avoidance 60%, depressed mood 42%, 46% anxiety and ideas of reference 44%. In 36% of the 55 cases described an event that is identified as a trigger. The most common treatment is first antidepressants, second antipsychotics and thirdly psychotherapy, with an overall efficiency of 39%.
Conclusions: The ORS is a clinically well defined syndrome, which would support the idea of being included in the appendix of DSM-5, as an independent entity. The avoidance behaviour and the traumatic event are the more consistent data. An integrative model is propose. It also presents the clinical description and results of functional magnetic resonance imaging of a clinical case.