Relationships between pathologic subjective halitosis, olfactory reference syndrome, and social anxiety in young Japanese women

Abstract

BackgroundPathologic subjective halitosis is known as a halitosis complaint without objective confirmation of halitosis by others or by halitometer measurements; it has been reported to be associated with social anxiety disorder. Olfactory reference syndrome is a preoccupation with the false belief that one emits a foul and offensive body odor. Generally, patients with olfactory reference syndrome are concerned with multiple body parts. However, the mouth is known to be the most common source of body odor for those with olfactory reference syndrome, which could imply that the two conditions share similar features. Therefore, we investigated potential causal relationships among pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupations with body part odors.MethodsA total of 1360 female students (mean age 19.6 ± 1.1 years) answered a self-administered questionnaire regarding pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupation with odors of body parts such as mouth, body, armpits, and feet. The scale for pathologic subjective halitosis followed that developed by Tsunoda et al.; participants were divided into three groups based on their scores (i.e., levels of pathologic subjective halitosis). A Bayesian network was used to analyze causal relationships between pathologic subjective halitosis, olfactory reference syndrome, social anxiety, and preoccupations with body part odors.ResultsWe found statistically significant differences in the results for olfactory reference syndrome and social anxiety among the various levels of pathologic subjective halitosis (P < 0.001). Residual analyses indicated that students with severe levels of pathologic subjective halitosis showed greater preoccupations with mouth and body odors (P < 0.05). Bayesian network analysis showed that social anxiety directly influenced pathologic subjective halitosis and olfactory reference syndrome. Preoccupations with mouth and body odors also influenced pathologic subjective halitosis.ConclusionsSocial anxiety may be a causal factor of pathologic subjective halitosis and olfactory reference syndrome.

The Study of Psychopathology from the Network Analysis Perspective: A Systematic Review

“…NA has also been used to study less known anxiety syndromes such as olfactory reference syndrome. Tsuruta et al [38] study revealed that SA may play a key role in the onset of fear to bodily odors.…”

“…Table 1). Tsuruta et al [38] innovatively examined the association among SA symptoms and cognitive functioning and found that orienting attention to non-emotional material was linked to fear of social situations, which impacted the social experience by triggering avoidance of social behaviors. NA has also been used to study less known anxiety syndromes such as olfactory reference syndrome.…”

“…Central nodes are largely interconnected to other nodes and their variations are more likely to affect the other nodes in the network. It has been proposed that identifying central nodes would be valuable in identifying important symptoms and in guiding which symptoms should be given priority in interventions [11, 16, 24, 38, 42, 43]. Moreover, centrality indexes may also be helpful in making predictions about recovery and prognosis.…”

Application of green tea extracts epigallocatechin‐3‐gallate in dental materials: Recent progress and perspectives

“…It is a common disease in the oral and will bring some social anxiety to patients (Bicak, 2018). The main source of halitosis is the volatile sulfur-containing compounds (VSCs), produced by some bacteria, such as hydrogen sulfide, methyl mercaptan and so on, as well as some volatile aromatic compounds such as indole also playing a role in causing odor (Tsuruta et al, 2017). Halitosis is caused by bacteria in the mouth.…”

Psychological characteristics of Chinese patients with genuine halitosis

“…Although researchers have explored various aspects of halitosis, the research on the association of halitosis with psychology aspects has just begun. Many scholars have respectively adopted different psychological assessment scales to evaluate the impact of halitosis on psychological status, but with different focuses (Kishi, Abe, & Yonemitsu, 2005;Tsuruta et al, 2017;Zaitsu et al, 2011). Therefore, obtaining uniform and repeat- teeth, use of denture, orthodontic treatment, maxillofacial trauma/ surgery) and other socio-demographic status (such as employment, independent living, remission without medication, improved relationships, visits to dentist, marital status, living alone or with family, handicaps, etc.)…”