The term “olfactory reference syndrome” (ORS), introduced by Pryse-Phillips in 1971, is a persistent false belief and preoccupation with body odor accompanied by significant distress and functional impairment. Nowadays, it is not a distinct syndrome and it is currently classified as a delusional or obsessive-compulsive disorder.

Review the history of ORSs classification and discuss why it should be considered as a separate diagnostic in the current health care classification systems.

Description of a clinical case of a 36-year-old man and review the published articles on ORS by using PubMed database with the keywords: “olfactory reference syndrome”, “chronic olfactory paranoid syndrome”, “hallucinations of smell”, “chronic olfactory paranoid syndrome”, “delusions of bromosis” and “taijin kyofusho”.

The published literature on ORS spans more than a century and provides consistent descriptions of its clinical features but nowadays is not explicitly mentioned in current classification systems as Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Statistical Classification of Diseases and Related Health Problems (ICD). ORS is overlap with different diagnostics such as delusional disorder, body dysmorphic disorder, obsessive-compulsive disorder, and hypochondriasis.

Right now, it is not clear how the ORSs should best be classified so we consider interesting to include it as a separate diagnosis in our set classifications, since we understand that an adjusted diagnosis is important in order to help patients and therapists to work on a treatment and to establish a more accurate prognosis.

The authors have not supplied their declaration of competing interest.