First described as a case series by Pryse-Phillips in 1971, Olfactory Reference Syndrome (ORS) has been increasingly reported in the scientific literature. Although current classifications do not consider ORS as a unique clinical entity, its existence is widely acknowledged. Different approaches to treatment have been described.

1) Portray the clinical features and treatment response of a patient with ORS. 2) Summarize knowledge on different treatment options for ORS.

We present the case of a teenager with major depressive disorder who developed the delusional belief of emitting a foul smell (without any other psychotic symptoms), and report his response to antidepressants and cognitive-behavioral therapy. Subsequently, we embark on a literature review on pharmacological and non-pharmacological options for patients with ORS.

We conducted a literature review in different databases using the keyword ’olfactory reference syndrome’. Papers published from 1971 to 2014 were selected on the basis of availability, relevant information in the title/abstract, and language (English, Spanish or Portuguese).

A brief summary is presented on the treatment options found in selected papers.

Different treatment approaches have proven beneficial for patients with ORS. This may reflect, however, a diversity of mechanisms by which this ailment is generated. More research on the physiopathology of ORS might result in better treatment outcomes.