Gen Hosp Psychiatry 33 (4): 398 - 406, 2011. doi: 10.1016 / j. genhosppsych.2011.04.004 Symptoms and Signs of Olfactory Reference Disorder Patients with olfactory reference disorder are preoccupied, usually for many hours a day, with a distressing or impairing belief that they emit one or more foul or offensive body odors, which are not perceived by others or are actually only slight.