Delusional smell

Of the Delusional smell is a delusional content that makes patients believe in a repulsive odor. Superordinate diseases such as schizophrenia, obsessive-compulsive disorder or organic brain damage play a role in the development of madness. The treatment takes place in a combination of medication and therapy.

What is delusional odor?

The group of delusional diseases contains different clinical pictures of the psyche. For example, delusional diseases differ significantly with their delusional content. In the delusional odor, the content of the delusion corresponds to a bad body odor. Those affected are obsessed with the thought that their smell is offensive to others.

The delusional odor is also known as bromidrosiphobia or bromosis and was originally described in the specialist literature against the culture-specific background of Japan. Taijin Kyōfushō is considered to be the first to describe it. Since the 1970s, the insane content has also found its way into English-language publications. The clinical picture was thus removed from the Japanese context and has since been known as the Olfactory Reference Syndrome.

The disorder is a rather rare form of delusional content. In the meantime, the delusional odor is no longer a separate, monosymptomatic disorder, but is placed in the context of mental illnesses such as obsessive-compulsive disorder, schizophrenia and psychosyndromes.

causes

The causes of the delusional odor can be cultural and individually learned misjudgments. In addition, different primary diseases can lead to the symptomatic picture of a delusional odor. Paranoid schizophrenia is one of the best-known diseases with delusional symptoms.

In the case of paranoid schizophrenia, the delusion is mostly ego-systonic. That means that the patients perceive the bad smell as an absolutely logical and natural part of their personality. As a symptom of obsessive-compulsive personality disorders, the obsession with odor can also be ego-systonic.

In contrast, ego dystonia is often present in the context of obsessive-compulsive disorder. In this case, the patients are aware that their idea of ​​the bad smell is incorrect. In some cases, the delusional odor was also attributed to organic brain damage.

In this context, for example, degenerative diseases come into question as the primary cause of the delusional disease. There are often fluid transitions between the possible causes.

Patients with delusional odor suffer from a relatively characteristic series of misperceptions and incorrect evaluations. They think they smell offensive. This impression is entirely subjective and differs from objective reality.

Many patients speak of abnormal olfactory sensations in their own person, which occur primarily depending on their environment. They often have the feeling that the gestures, facial expressions and behavior of other people in contact with them are inevitably related to their obnoxious body odor. They often search obsessively for organic diseases that can explain the subjectively perceived stench of their body.

They resort to excessive use of perfumes and other means to control their odor.Since they are plagued by social anxiety because of their smell, shame and social withdrawal often set in. Depending on the primary cause, the delusion is associated with other symptoms and is perceived either as belonging to the personality or as being disruptive to the personality.

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Diseases with this symptom

• Catatonic schizophrenia
• schizophrenia
• Compulsive Personality Disorder
• Brain tumor

• Paranoid schizophrenia
• Obsessive-compulsive disorder
• dementia
• Cerebral hemorrhage

• Schizoaffective Disorders
• Organic psychosyndrome
• Encephalitis
• concussion

Diagnosis & course

The delusional odor has so far mainly been treated in the context of case collections. A diagnosis according to ICD-10 or DSM is hardly feasible due to the fluid transition between causes. Basically, the diagnosis is made by a psychologist or psychotherapist, although in some cases a neurologist is used for the diagnosis.

Causal disorders of the brain's organics can be detected by means of imaging such as CT or MRI. Since the delusional odor is usually in the context of other diseases of the psyche and thus only corresponds to a symptom, it is often referred to as delusional symptoms to cover larger clinical pictures such as obsessive-compulsive disorder.

The prognosis for the patient depends on the parent disease. I-systonic delusional symptoms are usually worse to treat than I-dystonic delusional symptoms due to the lack of knowledge about their inconsistency.

Complications

The delusional odor is a mental disorder that is very difficult to treat. The patients believe they have a very unpleasant odor and the therapy is usually carried out with tablets. Although this treatment can contain the cause of this illness, it does not cure this mental disorder. Psychotherapy would be called for here, but this is rejected by many patients. This therapy would be particularly important, because it makes it clear that body odor is by no means repulsive to other people and that the perception of those affected must be changed.

A cure is seldom achieved simply because the patient has to "cooperate". The symptoms can be contained by the medication, so the patient is “sedated” with the tablets. However, it is far from cured, and the causes of this disease are very different. These diseases are associated with many misperceptions, the patients have their own opinion, which is miles away from reality.

Those affected draw wrong conclusions from other people's gestures, they firmly believe that the facial expressions and gestures of these people are related to their unpleasant smell. Often they look for organic diseases to explain the repulsive smell. Although this “stench” is only felt subjectively, people with this disease are withdrawing more and more and hardly take part in social life.

When should you go to the doctor?

It is normal to worry about your own well-groomed appearance. This includes checking for a possible body odor. This control is even desirable, because body odor is almost always perceived by others as repulsive. It is also known that one's own body odor is perceived less intensely by oneself than by others. As with the use of perfume, the naturally existing odor also has a habituation effect.

However, anyone who is constantly worried about smelling unpleasant, although those around them confirm the opposite when asked and there are no other suggestive reactions, should think about a doctor's visit. It is possible that there is an organic health disorder present. The first point of contact should be the family doctor. In general, he has known his patient for years and can adequately assess their concern. Delusions of self-odor or perceived self-odor can have a health background or be due to certain medications. Sometimes the personal environment is too polite to answer questions honestly. If necessary, the family doctor will arrange for further examinations with specialist colleagues: above all psychiatrists, psychologists or psychotherapists.

A delusional odor can be based on a mental disorder. Often the person affected lacks self-knowledge. Here, family and friends are asked to organize medical treatment for someone who suffers from delusional odor.

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Treatment & Therapy

The treatment of patients with delusional odor depends on the overall cause. Depending on the underlying disorder, various therapeutic approaches can be used. One of them is conservative drug treatment.

This form of treatment is not suitable for combating the causes and only counteracts the symptom itself. The patients may be temporarily asymptomatic due to drug treatment. However, this lack of symptoms is not to be equated with a cure, since the cause is not counteracted.

Medicines such as neuroleptics or clomipramine are used for symptomatic treatment. Which drugs are more suitable is decided with the primary disease. A causal form of treatment is psychotherapy, which in the case of self-odor madness usually takes place in the form of group therapies or at least in combination with group therapy.

In addition, cognitive behavioral therapy can be offered in individual cases, in which one's own body odor is reassessed and the patient's perception is changed. The form of treatment of cognitive behavioral therapy is particularly suitable for culturally or otherwise upbringing-induced causes.

In the context of organic brain damage, the primary aim is to treat the causative disease. For degenerative diseases there are no curative drugs available, but at least they can delay the disease. Sometimes the most difficult to treat is delusional odor in the context of schizophrenia. A causal cure is usually not achieved in this context. However, antipsychotics can weaken acute phases.

Outlook & forecast

The delusional odor is a purely psychological problem, which is why the delusional odor should also be treated by a psychologist. The affected person does not really suffer from the bad smell, they just imagine this symptom. This creates social fears and exclusion.

The person concerned tries to interpret every gesture and every remark made by other people on their own body odor and therefore always indicates that their own odor is not pleasant for other people. This leads to stressful situations, especially when the person comes into contact with many people. Often those affected look for a cause in organic diseases of the body and imagine certain diseases. The result is frequent visits to the doctor, even though there is no real problem. As a result, the job can also be neglected, which can lead to problems with the employer.

A far worse symptom is the constant perfuming and washing of the body with a delusional odor. This is to avoid that your own body has an unpleasant smell. However, permanent washing damages the natural protective layer of the skin and the skin becomes itchy.

In any case, the delusional odor should be treated with the help of a doctor. Treatment can take several months.

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prevention

The delusional odor can have numerous causes. The symptom can only be prevented to the extent that these causes can be prevented. Since degenerative brain diseases, as well as diseases such as schizophrenia, often have hereditary factors, a full prevention is as good as impossible.

You can do that yourself

The delusional odor is in most cases a psychological problem. Therefore, a consultation with a psychologist should always be arranged in order to identify the causes of the delusional odor and to be able to combat it in a targeted manner.

The delusional odor very often leads to compulsive washing and perfuming. This should be limited in any case, as this behavior destroys the natural protective layer of the skin. Ideally, the person concerned should refrain from taking perfume and other detergents with them when they are out and about. Perfuming and washing is only necessary before leaving the apartment.

Should the obsession with one's own smell get stronger again, this often has certain triggers, including stress above all. Stress should be avoided, it is also useful to seek distractions so that the obsession with one's own odor can be avoided. Talking to other people about your own problem is always helpful. A doctor can identify the causes of the problem and target them. Unfortunately, there are few self-help aids that the person concerned can take or carry out himself or herself. If the skin is irritated by the compulsive washing and perfuming, it is high time to seek the advice of a doctor.