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Is Olfactory Reference Syndrome an Obsessive-Compulsive Spectrum Disorder?

Two Cases and a Discussion

Received June 5, 1996; revised November 6, 1996; accepted November 12, 1996. From the Departments of Psychiatry and Nuclear Medicine, University of Stellenbosch, Tygerberg, South Africa. Address correspondence to Dr. Stein, Department of Psychiatry, University of Stellenbosch, P.O. Box 19063, Tygerberg 7505, South Africa.

A number of disorders characterized by intrusive repetitive symptoms and varying degrees of insight may overlap phenomenologically and neurobiologically with obsessive-compulsive disorder (OCD). There is a question as to whether olfactory reference syndrome, a disorder characterized by persistent preoccupations about body odor accompanied by shame and embarrassment, is also an OCD spectrum disorder. Two cases of olfactory reference syndrome, with accompanying phenomenological and neurobiological data, are presented in order to discuss the possible overlap with OCD. A number of phenomenological and neurobiological features in these patients were at least partially reminiscent of OCD. In particular, despite having poor insight, both patients demonstrated significant improvement upon treatment with a serotonin reuptake inhibitor.

Key Words: Olfactory Reference Syndrome; Obsessive-Compulsive Disorder; Serotonin

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