A Case Report of Olfactory Reference Disorder with Childhood Trauma: Aetiological and neurobiological insights

We report a 22-year-old male, who presented in 2020 to a clinic in Kahramanmaraş, Turkey, with a 5-year history of a fixed preoccupation with the belief of emitting a 'plastic smell' from his anal region. This case illustrates a clinically significant link with a history of childhood sexual abuse. The patient was diagnosed with olfactory reference disorder (ORD) with poor insight and comorbid depressive disorder, based on ICD-11 and DSM-5-TR criteria. Extensive medical workups ruled out organic causes. He responded well to a combination therapy of sertraline and aripiprazole, showing significant symptom reduction. This case supports a diathesis-stress model where ORD can manifest as a somatic metaphor for trauma, mediated by experiential avoidance. It highlights the importance of trauma assessment and a neurobiologically informed psychopharmacological approach in managing ORD.