体征/症状 可以归类为嗅觉牵连综合征 (ORS) 的一个类型，这种疾病表现为强烈认为自己发出恶臭或讨厌的身体气味，但别人感觉不到。[3]Phillips KA, Gunderson C, Gruber U, et al. Delusions of body malodour; the olfactory reference syndrome. In: Brewer W, Castle D, Pantelis C, eds. Olfaction and the brain. New York, NY: Cambridge University Press; 2006:334-353.[4]Feusner JD, Phillips KA, Stein DJ. Olfactory reference syndrome: issues for DSM-V. Depress Anxiety. 2010;27:592-599.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247225/http://www.ncbi.nlm.nih.gov/pubmed/20533369?tool=bestpractice.com[5]Bishop ER Jr. An olfactory reference syndrome: monosymptomatic hypochondriasis. J Clin Psychiatry 1980;41:57-59.http://www.ncbi.nlm.nih.gov/pubmed/7354010?tool=bestpractice.com患者可能报告来自口腔、生殖器、直肠或皮肤的恶臭气味，[4]Feusner JD, Phillips KA, Stein DJ. Olfactory reference syndrome: issues for DSM-V. Depress Anxiety. 2010;27:592-599.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247225/http://www.ncbi.nlm.nih.gov/pubmed/20533369?tool=bestpractice.com[5]Bishop ER Jr. An olfactory reference syndrome: monosymptomatic hypochondriasis. J Clin Psychiatry 1980;41:57-59.http://www.ncbi.nlm.nih.gov/pubmed/7354010?tool=bestpractice.com伴有不同程度的自知力。这种信念经常伴有牵连观念或幻觉；例如认为其他人以消极方式特别关注这种气味（例如与气味相关的擦鼻子或厌恶地转身离开）。[6]Phillips KA, Menard W. Olfactory reference syndrome: demographic and clinical features of imagined body odor. Gen Hosp Psychiatry. 2011;33:398-406.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139109/http://www.ncbi.nlm.nih.gov/pubmed/21762838?tool=bestpractice.com此外，许多患者有重复行为，例如过分地闻自己、刷牙或洗浴。《精神疾病诊断与统计手册》第五版 (DSM-5) 在强迫症及相关障碍下提到了 ORS 的临床表现，[7]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. (DSM-5). Washington, DC: American Psychiatric Publishing; 2013.但这并不是一个独立的诊断。[8]Veale D, Matsunaga H. Body dysmorphic disorder and olfactory reference disorder: proposals for ICD-11. Rev Bras Psiquiatr. 2014;36(suppl 1):14-20.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462014000400014&lng=en&nrm=iso&tlng=enhttp://www.ncbi.nlm.nih.gov/pubmed/25388608?tool=bestpractice.com
