array:23 [ "pii" => "S1134593418300010" "issn" => "11345934" "doi" => "10.1016/j.psiq.2018.01.001" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "229" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Psiquiatría y Sociedad Española de Psiquiatría Biológica" "copyrightAnyo" => "2018" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Psiquiatr Biol . 2018;25:29-31" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 81 "formatos" => array:2 [ "HTML" => 35 "PDF" => 46 ] ] "itemSiguiente" => array:18 [ "pii" => "S113459341830006X" "issn" => "11345934" "doi" => "10.1016/j.psiq.2018.02.001" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "234" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Psiquiatría y Sociedad Española de Psiquiatría Biológica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Psiquiatr Biol . 2018;25:32-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 65 "formatos" => array:2 [ "HTML" => 22 "PDF" => 43 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso clínico</span>" "titulo" => "El reto del diagnóstico comórbido en psiquiatría infantojuvenil" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "32" "paginaFinal" => "35" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The challenge of the comorbid diagnosis in childhood and adolescent psychiatry" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1046 "Ancho" => 800 "Tamanyo" => 69714 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">RMN cerebral. Corte coronal. Secuencia Flair potenciada en T2. Descripción: asimetría morfológica de patrón giral que asocia hiperintensidad. Posible displasia cortical parietal derecha.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Celia González Soria, Soraya Geijo Uribe, Beatriz Mongil López, Mercedes Vaquero Casado, Laila Al Chaal Marcos" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Celia" "apellidos" => "González Soria" ] 1 => array:2 [ "nombre" => "Soraya" "apellidos" => "Geijo Uribe" ] 2 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Mongil López" ] 3 => array:2 [ "nombre" => "Mercedes" "apellidos" => "Vaquero Casado" ] 4 => array:2 [ "nombre" => "Laila" "apellidos" => "Al Chaal Marcos" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113459341830006X?idApp=UINPBA00004N" "url" => "/11345934/0000002500000001/v1_201804130414/S113459341830006X/v1_201804130414/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1134593418300022" "issn" => "11345934" "doi" => "10.1016/j.psiq.2018.01.002" "estado" => "S300" "fechaPublicacion" => "2018-01-01" "aid" => "230" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Psiquiatría y Sociedad Española de Psiquiatría Biológica" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Psiquiatr Biol . 2018;25:26-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 109 "formatos" => array:2 [ "HTML" => 47 "PDF" => 62 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso clínico</span>" "titulo" => "Episodio maniaco con síntomas psicóticos tras desintoxicación de heroína: estudio de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "26" "paginaFinal" => "28" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Manic episode with psychotic symptoms after heroin detoxification: A case study" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Adrián Neyra del Rosario" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Adrián" "apellidos" => "Neyra del Rosario" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134593418300022?idApp=UINPBA00004N" "url" => "/11345934/0000002500000001/v1_201804130414/S1134593418300022/v1_201804130414/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case Report</span>" "titulo" => "Successful treatment of olfactory reference syndrome with clomipramine" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "29" "paginaFinal" => "31" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Murat Eren Ozen, Murat Aydin, Cagri Derici, Mehmet Hamdi Orum, Aysun Kalenderoglu" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Murat Eren" "apellidos" => "Ozen" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 1 => array:3 [ "nombre" => "Murat" "apellidos" => "Aydin" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 2 => array:3 [ "nombre" => "Cagri" "apellidos" => "Derici" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:4 [ "nombre" => "Mehmet Hamdi" "apellidos" => "Orum" "email" => array:1 [ 0 => "mhorum@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 4 => array:3 [ "nombre" => "Aysun" "apellidos" => "Kalenderoglu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Adana Private Hospital, Psychiatry Clinic, Adana, Turkey" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Dental Professional, Private Clinical Practice, Adana, Turkey" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Adana Numune Training and Research Hospital, Ear, Nose and Throat Clinic, Adana, Turkey" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Adiyaman University Faculty of Medicine, Department of Psychiatry, Adiyaman, Turkey" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Halitorium-Halitosis Research Group, Turkey<a class="elsevierStyleCrossRef" href="#fn1"><span class="elsevierStyleSup">1</span></a>" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento eficaz del síndrome de referencia olfativo con clomipramina" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Halitosis is a term that defines chronic, endogenous malodour which is classified from type 0 to 5; which corresponds to physiological, oral, airway, gastroesophageal, blood–borne and subjective, respectively.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">1</span></a> Subjective halitosis is featured by malodour that cannot be confirmed by others, further, despite the patient's complaints, there is not any local or systemic problem. Subjective halitosis cases may be misdiagnosed by specialists (including internal medicine, ear-nose-throat, endocrinology) as much as 27% indicated.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a> Subjective halitosis is defined in two clinical forms; psychogenic (anxiety, obsessional or delusional disorders including olfactory reference syndrome (ORS) and neurogenic (cacosmia-bad odour sense, phantosmia-imaginary odour sense, chemosensory dysfunctions).<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Olfactory syndrome is a condition in which a person mistakenly believes that he or she emits an unpleasant body odour, but not perceived by others and is usually described by patients where this belief is usually accompanied by ideas of reference. In case reports and case series, as a result of embarrassment and suffering, individuals with ORS have been shown to engage in time-consuming rituals (repetitive behaviours, including sniffing the body, bathing excessively or attempting to mask the odour) aimed at masking or fixing the odour (usually originating in regions naturally associated with bad odour, like the mouth, armpits and genital/anal regions), avoid social situations, experience impaired work functioning, exhibit significant distress, report suicidal ideation and past suicide attempts, and sometimes become housebound and social avoidance.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> Odours are usually regarding the bodily originated ones. Uncommonly, patients have concerns on emitting non-bodily odours such as burned rags.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">5</span></a> Or rotten onions.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Despite the marked severity and impairment associated with ORS, empirical research on ORS is extremely limited. Sufferers frequently seek other health professionals (dentists, dermatologists, gastroenterologists, ear-nose-throat specialists), trying to solve the alleged problem.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">7,8</span></a> At present, ORS is one of the conditions mentioned in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5)<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">9</span></a> which is not categorized as a separate disorder.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">This case report illustrates a patient representing an ORS patient referred by halitosis clinics and evaluated, treated by a psychiatrist with clomipramine. In the literature, so far, clomipramine is shown to be effective in the treatment of ORS by this paper too. We suggest clomipramine would be useful in treating ORS patients especially with insight. In addition, this clinical situation must be in the attention of medical settings (psychiatrists, ear-nose-throat specialists and dentists) and may be kept in mind during clinical, treatment and differential diagnosis processes.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case presentation</span><p id="par0025" class="elsevierStylePara elsevierViewall">A 51-year-old divorced man who is directed/oriented by his mother to the psychiatry department with an increasing frequency of experiencing abnormal odour from his mouth since his childhood. He complained of – at least last two-year of constant smelling a very unpleasant oral odour that was like ‘burning plastic mixed with rotting fish’ had gradually enhanced. In the beginning, in first 2 years, the odour would increase in only/inly in leisure time at home. The intensity was quite less than the following years. Then this odour perception and the intensity became long-lasting and at all places he has been (all social and work areas). For the last 4 years, odour perception and restlessness became unbearable. So, he did not share the places where people has been/were. He became a “loner” sometime later. He resigned from his job and began to work on computer at home to earn his money and not to join public places. When he had to join some groups of family members or with people in the market places, he had chosen the latest times when the people were about to leave there. Some gestures of people precipitated the so-called odour he emitted. When he saw any person closing their mouth, itching or caressing their face and nose, giggling of people to whom his eyes contacted to them reminded his feelings and ideas of emitting odour. For the last year, he rejected to join his own family at home. He slept all day long and worked at nights so not to come across with family members. He did not share the places or times with them/his family. Especially, her mother worried about him and insisted to admit a professional help. Before his admittance to the dentist, his mother's persistence lasted for about 6 months. Mother's forceful motivation made him accept to apply, his dentist's evaluation did not reveal any loss of smell or taste. His dentist clearly told that this case was really a psychiatric situation. He accepted to admit our psychiatry department to cure his illness. Although long lasting of his illness (approximately over 30 years) and almost seemingly loss of insight, his willingness to psychiatric treatment was a big puzzling.</p><p id="par0030" class="elsevierStylePara elsevierViewall">He was regularly brushing her teeth and tongue; he was also doing a 3-min mouth washing after every brushing. He was not a smoker, a drinker or taking any medications regularly. Any systemic problem, including postnasal drip, enteric parasite, constipation, gastroesophageal reflux, allergy were not detected. Halitosis examination was made with a previously described procedure.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">11</span></a> Saliva volume was 2.5<span class="elsevierStyleHsp" style=""></span>ml/min, pH was found 6.5 and H<span class="elsevierStyleInf">2</span>S level was less than 100<span class="elsevierStyleHsp" style=""></span>ppb was found. Any dental caries, bad dental restoration, pathologic periodontal pocket, tongue coating were not detected. Cranial computerized tomography scan showed no pathology. Neither nasal nor alveolar air found odorous. He is diagnosed as Type 5 (subjective halitosis).</p><p id="par0035" class="elsevierStylePara elsevierViewall">All workups with blood screen, cranial magnetic resonance imaging and electroencephalogram; neurological examinations did not reveal any pathological signs indicating neurological disorders such as epilepsy. No discordance was disclosed by her family members.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The case was diagnosed as ORS regarding his history, symptoms and signs. So far, he has not applied to a psychiatrist before and had not taken any psychotropic medications.</p><p id="par0045" class="elsevierStylePara elsevierViewall">His insight, easily convinced to have a psychiatric disorder and to accept the treatment made us to choose an antidepressant. Our experience with clomipramine<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">12</span></a> and case reports<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">13,14</span></a> with this agent made us chose this drug choice again. Clomipramine's twice Daily 75<span class="elsevierStyleHsp" style=""></span>mg was initiated and tolerated well. Although he showed approximately 40% relief after 1-month interval with this treatment. Addition of 75<span class="elsevierStyleHsp" style=""></span>mg clomipramine during the 2nd month interval resulted with 60% improvement. After 2-months, 225<span class="elsevierStyleHsp" style=""></span>mg/day dosage reached a good result, as a consequence he began to socialize. By the end of 3rd month, treatment reached 70% healing. An addition of 75<span class="elsevierStyleHsp" style=""></span>mg/day to 225<span class="elsevierStyleHsp" style=""></span>mg/day dosage (totally 300<span class="elsevierStyleHsp" style=""></span>mg/day), following the end of the 4th month, he felt very well indeed. Monitoring of him showed us; in two months, the odour so-called he had emitted diminished. During 3rd month he began to go outside with other friends, and gathered with his family in their meetings. By the end of 4th month, he did not think of others’ gestures to remind him as he emits an odour and annoys people around him. Loneliness became a boring situation, he confessed.</p><p id="par0050" class="elsevierStylePara elsevierViewall">After a follow-up of 10-months with 300<span class="elsevierStyleHsp" style=""></span>mg/day of clomipramine, revealed that his thoughts about others’ behaviours (closing their mouth, itching or caressing their face nose, giggling of people when his eyes contacted) chanced thoroughly and did not remind him any of his illness.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">First description of ORS is made with 36 patients.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> Core symptom was contrite reaction as emphasized. ORS begins nearly age of 20s. Those patients with ORS are usually deeply ashamed, embarrassed, self-abasing and sensitive reaction of people who believe that their bodies emit odour and think they are source of displeasure or disgust to people around them. They are restricted to their own area, avoid the social places, some show excessive behaviour to dispel the odour they emanate by changing clothes, using deodorants.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Some other reports of ORS have indicated that the majority of cases have poor insight, while some cases feel that their beliefs and reactions are excessive.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a> In our case, in 30-year duration, patient had poor insight regarding his olfactory symptoms. Previous studies of pharmacotherapy for ORS have reported the effectiveness of antidepressants including tricyclics and serotonergic agents, including selective serotonin reuptake inhibitors (SSRIs)<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">16,17</span></a> and clomipramine.<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">12–14</span></a> However, although ORS beliefs are often delusional, treatments with SSRIs were found more efficacious than with antipsychotics.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">7,18</span></a> In a study with ORS patients, SSRIs are shown to be effective. On the other hand, some patients with such a condition have been shown to be treatment-resistant.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">In our case, symptomatic features are consistent with ORS definition and clinical presentation in other reports. The patient was restricted to his social and domestic excursion because of his avoidance behaviour. Brushing teeth was not a ritual as seen OCD, since this behaviour was only to dispel odour. Although observation of depression or depressive symptoms in ORS patients, our case did not represent any of the depressive features. His avoidance and choosing to be a “loner” was accepted due to his complaints, not to depression. As indicated in the literature and in the nature of ORS, our patient has not admitted any specialist before. They had frequently consulted medical specialists,<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> a reported case underwent unnecessary surgery and was referred twice by surgeons,<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">8</span></a> but rarely received psychiatric treatment.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Most of the patients with ORS are males,<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">4</span></a> as our patient was. Many patients reported in literature were significantly younger and symptoms begin around age of 20 years. Our patient's symptoms also began 30 years before his admittance when he was 51 years old, in accordance with the onset of ORS clinics in reports and literature. Progress to schizophrenia was also described but our patient did not represent any psychotic social regression or withdrawal. His avoidance was only due to his odour problem, not a result of any psychotic feature.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Indeed, the diagnosis of ORS remains a challenge due to its overlapping features with other psychiatric disorders and is only mentioned briefly in DSM-V. More epidemiological and clinical studies are needed to determine ORS prevalence and diagnostic status, which is the first step to achieving evidence-based treatment approaches. In summary, further studies regarding symptoms, biomarkers and outcomes are needed to fully disentangle ORS from existing depressive, anxiety and obsessive compulsive spectrum disorders. Thus further studies are needed to establish its diagnostic criteria and also to understand the illness better in order to treat as well as reduce the morbidity due to disease.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Financial disclosure</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors declared that this study has received no financial support.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflict of interest</span><p id="par0085" class="elsevierStylePara elsevierViewall">No conflict of interest was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1014874" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec973522" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1014873" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec973523" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case presentation" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Financial disclosure" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interest" ] 9 => array:2 [ "identificador" => "xack342438" "titulo" => "Acknowledgement" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-08-24" "fechaAceptado" => "2018-01-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec973522" "palabras" => array:4 [ 0 => "Olfactory reference syndrome" 1 => "Clomipramine" 2 => "Subjective halitosis" 3 => "Antidepressant" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec973523" "palabras" => array:4 [ 0 => "Síndrome de referencia olfativo" 1 => "Clomipramina" 2 => "Halitosis subjetiva" 3 => "Antidepresivo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Subjective halitosis is a chronic disorder, and cannot be easily identified or measured by objective methods. The patients who are complaining with subjective halitosis usually refer to dentists, yet they reject to psychiatric consultations. One of the causes is olfactory reference syndrome (ORS) which is accepted as delusional or obsessive thoughts. ORS patients are usually refer to others’ behaviours; people who are closing their mouth, coughing and touching their nose, opening window, turning faces to another side to protect themselves. These are the signs as to emitting malodour which patients misinterpret. This paper illustrates a 51-old male who suffers from halitosis since 30 years which is diagnosed as ORS and treated with clomipramine.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La halitosis subjetiva es un trastorno crónico y no es fácilmente identificable o cuantificable con métodos objetivos. Los pacientes que se quejan de halitosis subjetiva por lo general consultan al dentista, pero evitan la consulta psiquiátrica. Una de las causas es el síndrome de referencia olfativo (SRO), que se reconoce como pensamientos delirantes u obsesivos. Los pacientes con SRO generalmente hacen referencia a los comportamientos de los demás, personas que cierran la boca, tosen y se tocan la nariz, abren la ventana o giran la cara hacia otro lado para protegerse. Estos son los signos del hecho de desprender mal aliento que los pacientes malinterpretan. Este artículo expone el caso de un varón de 51 años que sufre halitosis desde hace 30 años, que se diagnostica como SRO y se trata con clomipramina.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><a class="elsevierStyleInterRef" target="_blank" id="intr0005" href="http://www.halitorium.com/halitorium/index.html">http://www.halitorium.com/halitorium/index.html</a>.</p>" "identificador" => "fn1" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib0095" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Halitosis: a new definition and classification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Aydin" 1 => "C.N. Harvey-Woodworth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.bdj.2014.552" "Revista" => array:5 [ "tituloSerie" => "Br Dent J" "fecha" => "2014" "volumen" => "217" "paginaInicial" => "E1" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25012349" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0100" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breaking paradigms: a new definition for halitosis in the context of pseudo-halitosis and halitophobia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.P. Falcao" 1 => "C.N. Vieira" 2 => "R.F. Batista de Amorim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1088/1752-7155/6/1/017105" "Revista" => array:5 [ "tituloSerie" => "J Breath Res" "fecha" => "2012" "volumen" => "6" "paginaInicial" => "017105" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22368258" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0105" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subjective halitosis: definition and classification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.E. Ozen" 1 => "M. Aydin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J N J Dent Assoc" "fecha" => "2015" "volumen" => "86" "paginaInicial" => "20" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27156275" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0110" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An olfactory reference syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W. Pryse-Phillips" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Psychiatr Scand" "fecha" => "1971" "volumen" => "47" "paginaInicial" => "484" "paginaFinal" => "509" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5146719" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0115" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of olfactory hallucination in a hypochondriacal prisoner" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.L. Harriman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Abnorm Soc Psychol" "fecha" => "1934" "volumen" => "29" "paginaInicial" => "457" "paginaFinal" => "458" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0120" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bromidrosiphobia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.L. Sutton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Med Assoc" "fecha" => "1919" "volumen" => "72" "paginaInicial" => "1267" "paginaFinal" => "1268" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0125" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Olfactory reference syndrome: demographic and clinical features of imagined body odor" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.A. Philips" 1 => "W. Menard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.genhosppsych.2011.04.004" "Revista" => array:6 [ "tituloSerie" => "Gen Hosp Psychiatry" "fecha" => "2011" "volumen" => "33" "paginaInicial" => "398" "paginaFinal" => "406" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21762838" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0130" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frontotemporal hypoperfusion detected by 99mTc HMPAO SPECT in a patient with olfactory reference syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Konuk" 1 => "L. Atik" 2 => "N. Atasoy" 3 => "M.B. Ugur" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.genhosppsych.2005.09.006" "Revista" => array:6 [ "tituloSerie" => "Gen Hosp Psychiatry" "fecha" => "2006" "volumen" => "28" "paginaInicial" => "174" "paginaFinal" => "177" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16516069" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0135" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic and statistical manual of mental disorders: DSM-5" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "American Psychiatric Association" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2013" "editorial" => "American Psychiatric Association" "editorialLocalizacion" => "Washington, D.C." ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0140" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delusional disorder and shared psychotic disorder" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.I. Kaplan" 1 => "J.B. Sadock" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:6 [ "editores" => "B.J.SadockV.A.Sadock" "paginaInicial" => "334" "paginaFinal" => "335" "edicion" => "11th ed." "serieTitulo" => "Synopsis of psychiatry: behavioral sciences/clinical psychiatry" "serieFecha" => "2015" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0145" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new measurement protocol to differentiate sources of halitosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Aydin" 1 => "M.E. Ozen" 2 => "U. Kirbiyik" 3 => "B. Evlice" 4 => "M. Ferguson" 5 => "I. Uzel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Odontol Scand" "fecha" => "2016" "volumen" => "11" "paginaInicial" => "1" "paginaFinal" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13079719" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0150" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unremitting halitosis: a case of olfactory reference syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.E. Ozen" 1 => "M. Aydin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Klinik Psikiyatri" "fecha" => "2016" "volumen" => "19" "paginaInicial" => "149" "paginaFinal" => "151" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0155" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Olfactory reference syndrome responds to clomipramine but not fluoxetine: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.A. Dominguez" 1 => "A. Puig" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Psychiatry" "fecha" => "1997" "volumen" => "58" "paginaInicial" => "497" "paginaFinal" => "498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9413419" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0160" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case with fear of emitting body odour resulted in successful treatment with clomipramine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Kizu" 1 => "N. Miyoshi" 2 => "Y. Yoshida" 3 => "T. Miyagishi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hokkaido Igaku Zasshi" "fecha" => "1994" "volumen" => "69" "paginaInicial" => "1477" "paginaFinal" => "1480" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7705756" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0165" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An olfactory reference syndrome – monosymptomatic hypochondriasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E.R. Bishop Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Psychiatry" "fecha" => "1980" "volumen" => "41" "paginaInicial" => "57" "paginaFinal" => "59" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7440526" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0170" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is olfactory reference syndrome an obsessive-compulsive spectrum disorder? Two cases and a discussion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.J. Stein" 1 => "L. Le Roux" 2 => "C. Bouwer" 3 => "B. van Heerden" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1176/jnp.10.1.96" "Revista" => array:6 [ "tituloSerie" => "J Neuropsychiatry Clin Neurosci" "fecha" => "1998" "volumen" => "10" "paginaInicial" => "96" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9547473" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0175" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Monosymptomatic hypochondriasis treated with tricyclic antidepressants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.W. Brotman" 1 => "M.A. Jenike" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1176/ajp.141.12.1608" "Revista" => array:6 [ "tituloSerie" => "Am J Psychiatry" "fecha" => "1984" "volumen" => "141" "paginaInicial" => "1608" "paginaFinal" => "1609" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6507666" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0180" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Delusions of body malodour the olfactory reference syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.A. Phillips" 1 => "C. Gunderson" 2 => "U. Gruber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Olfaction and the brain" "paginaInicial" => "334" "paginaFinal" => "353" "serieFecha" => "2006" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack342438" "titulo" => "Acknowledgement" "texto" => "<p id="par0090" class="elsevierStylePara elsevierViewall">None declared.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/11345934/0000002500000001/v1_201804130414/S1134593418300010/v1_201804130414/en/main.assets" "Apartado" => array:4 [ "identificador" => "20366" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Casos clínicos" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/11345934/0000002500000001/v1_201804130414/S1134593418300010/v1_201804130414/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1134593418300010?idApp=UINPBA00004N" ]
Información de la revista
Compartir
Descargar PDF
Más opciones de artículo
Case Report
Successful treatment of olfactory reference syndrome with clomipramine
Tratamiento eficaz del síndrome de referencia olfativo con clomipramina
Murat Eren Ozena,e, Murat Aydinb,e, Cagri Dericic, Mehmet Hamdi Orumd,
, Aysun Kalenderoglud
Autor para correspondencia