Olfactory Reference Disorder (6B22): Complete ICD-11 Coding Guide

1. Introduction

Olfactory Reference Syndrome (ORS) represents a complex psychiatric condition that is frequently underdiagnosed, characterized by persistent and distressing preoccupation that one is emitting an unpleasant body odor or foul breath that is, in reality, imperceptible or only minimally perceptible to other people. This condition, classified under code 6B22 in ICD-11, belongs to the spectrum of obsessive-compulsive and related disorders, reflecting its intrusive nature and the repetitive behaviors that characterize it.

The clinical importance of ORS lies in its devastating impact on the quality of life of affected individuals. Patients with this disorder frequently experience severe social isolation, significant occupational impairment, and intense psychological distress. Many avoid social situations, abandon professional opportunities, and develop psychiatric comorbidities such as depression and social anxiety. The disorder can begin in adolescence or early adulthood, a critical period for developing relationships and establishing oneself professionally.

From a public health perspective, ORS represents a significant challenge due to its limited recognition among healthcare professionals and the tendency of patients to initially seek help in non-psychiatric specialties, such as dermatology, gastroenterology, or dentistry. This journey through various specialists results in high costs for healthcare systems and delays in appropriate treatment.

Correct coding using code 6B22 is critical to ensure that patients receive appropriate evidence-based interventions, facilitate epidemiological research, allow adequate analysis of public health data, and ensure appropriate reimbursement of mental health services. The formal recognition of this condition in ICD-11 represents an important advance in validating the suffering of these patients.

2. Correct ICD-11 Code

Code: 6B22

Description: Olfactory Reference Disorder

Parent category: Obsessive-compulsive or related disorders

Official definition: Olfactory Reference Disorder is characterized by persistent preoccupation with the belief that one is emitting a body odor or breath perceived as bad or unpleasant, which is imperceptible or only slightly perceptible to others. Individuals experience a sense of excessive embarrassment in relation to the perceived odor, often with ideas of reference—that is, the conviction that people are noticing, judging, or talking about the odor.

In response to their preoccupations, individuals display repetitive and excessive behaviors, such as checking for body odor or checking the perceived source of the odor, seeking reassurance repeatedly, excessive attempts to camouflage, alter, or prevent the perceived odor, or marked avoidance of social situations or triggers that increase distress related to the perceived bad or unpleasant odor.

The symptoms are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. This definition emphasizes the egodystonic nature of the disorder and the characteristic pattern of compensatory behaviors that distinguish ORD from transient normal concerns about personal hygiene.

3. When to Use This Code

The code 6B22 should be applied in specific clinical scenarios where the central diagnostic criteria are clearly present:

Scenario 1: Concern with generalized body odor A 28-year-old patient presents with complaints that his body constantly emits a "rotten fish odor." Despite multiple dermatological consultations and normal laboratory examinations, including evaluation for trimethylaminuria, the patient remains convinced of the odor. He showers 6-8 times daily, applies deodorant excessively, and changed clothes three times during the consultation. He reports that coworkers cover their noses when he passes, an interpretation that persists even when neutral observers deny any odor. Code 6B22 is appropriate when there is this combination of persistent belief, repetitive checking/camouflage behaviors, and ideas of reference.

Scenario 2: Concern focused on halitosis A 35-year-old patient is convinced that her breath is unbearably foul, despite normal dental and gastroenterological evaluations. She consults three different dentists seeking confirmation, uses mouthwash 15-20 times daily, avoids face-to-face conversations, and lost her professional position due to refusal to participate in in-person meetings. She maintains a distance of at least two meters from other people and constantly covers her mouth when speaking. This pattern of specific concern with halitosis, accompanied by checking rituals and marked social avoidance, justifies code 6B22.

Scenario 3: Concern with genital odor A 24-year-old patient believes that his genital region emits a putrid odor that other people can detect even through clothing. He has undergone multiple urological and dermatological consultations without pathological findings. He avoids gyms, swimming pools, and any situation where he might be close to other people. He has developed elaborate hygiene rituals that consume 3-4 hours daily and uses multiple layers of clothing to "contain" the odor. Code 6B22 is indicated when the concern focuses on a specific body area with disproportionate compensatory behaviors.

Scenario 4: Multiple perceived sources of odor A 42-year-old patient alternates between concerns about axillary odor, vaginal odor, and halitosis, changing focus every few weeks. Regardless of the perceived source, she maintains a consistent pattern of compulsive checking, reassurance-seeking, and social avoidance. She carries a bag containing various hygiene products and frequently absents herself from commitments to "check" the odor. The presence of multiple olfactory concerns with a consistent behavioral pattern still falls under code 6B22.

Scenario 5: Onset following a stressful event A 19-year-old patient developed intense concern with body odor following an ambiguous comment from a classmate about "something smelling bad" in the classroom. Since then, he is convinced that he emits a rancid sweat odor, despite family and friends consistently denying any odor. He dropped out of college, avoids public transportation, and remains at home most of the time. When the disorder develops following an identifiable trigger but persists with disproportionate intensity and significant functional impairment, code 6B22 is appropriate.

Scenario 6: Comorbidity with elaborate camouflage behaviors A 31-year-old patient developed a complex system of "neutralizing" the perceived odor, including application of multiple products, use of specific clothing in a determined sequence, and avoidance of foods that "worsen" the odor. She spends significant financial resources on hygiene products and perfumes. These ritualized behaviors, combined with marked distress and functional impairment, confirm the diagnosis 6B22.

4. When NOT to Use This Code

It is fundamental to differentiate ORS from other conditions that may present with olfactory concerns:

Real medical conditions: Do not use 6B22 when there is objective evidence of a medical condition causing actual odor, such as trimethylaminuria (fish odor syndrome), bromhidrosis, cutaneous bacterial infections, severe periodontal disease, renal or hepatic insufficiency. In these cases, code the underlying medical condition. The crucial distinction is the presence of objective clinical findings and confirmation by independent examiners of the odor.

Body Dysmorphic Disorder (6B21): When the primary concern involves appearance perceived as defective (nose size, face shape, body asymmetry) and not body odor, use 6B21. Although there may be overlap, the primary focus differentiates the disorders. If the patient is concerned that their nose is too large AND that this causes odor, but the primary concern is with appearance, use 6B21.

Obsessive-Compulsive Disorder (6B20): When concerns with contamination or cleaning exist but are not specifically focused on exhaling unpleasant odor, use 6B20. For example, a patient who washes hands excessively out of fear of germs, but not out of concern that their hands smell bad. The distinction lies in the specific content of the obsessions.

Hypochondriasis/Illness Anxiety Disorder (6B23): When the concern is with having a serious disease that may cause odor (such as intestinal cancer), but the focus is on the feared disease and not on the odor itself, use 6B23. The patient with hypochondriasis fears the disease; the patient with ORS fears the social embarrassment of odor.

Social Phobia (6B04): Generalized social anxiety without specific and persistent concern with body odor should be coded as social phobia. The difference lies in specificity: ORS involves conviction of actual odor; social phobia involves fear of negative evaluation without specific fixed belief.

Normal hygiene concerns: Transitory or proportional concerns with personal hygiene, without excessive behaviors, ideas of reference, or significant functional impairment, do not constitute mental disorder and should not receive a diagnostic code.

5. Coding Step by Step

Step 1: Assess diagnostic criteria

Confirmation of diagnosis requires systematic evaluation of core criteria. Begin with structured clinical interview exploring the nature, intensity, and duration of olfactory concerns. Specifically question: what odor does the patient believe they are emitting, when did the concern start, how intense does the patient consider the odor, do other people confirm or deny the odor, and how much daily time is spent thinking about this.

Assess the presence of ideas of reference by asking whether the patient perceives specific reactions from others (covering nose, moving away, making comments) and how frequently they interpret neutral behaviors as related to the perceived odor. Investigate repetitive behaviors in detail: bathing frequency, use of hygiene products, checking rituals, reassurance-seeking, and avoidance patterns.

Useful instruments include scales specific to ORS when available, insight scales (to assess degree of conviction), quality of life questionnaires, and scales of social and occupational functioning. The evaluation should include complete medical history to exclude organic causes of actual odor.

Step 2: Verify specifiers

Although ICD-11 does not establish formal specifiers for 6B22, it is clinically useful to document characteristics that influence treatment and prognosis. Assess the degree of insight: does the patient recognize that their concerns may be excessive (good insight), are they uncertain (reasonable insight), or are they completely convinced of the reality of the odor (poor/absent insight)? Patients with absent insight may require different therapeutic approaches.

Document severity through the level of functional impairment: mild (some discomfort but preserved functioning), moderate (clear interference in social or occupational activities), or severe (marked incapacity, complete social isolation). The duration of symptoms should also be recorded, distinguishing recent cases (less than 6 months) from chronic ones (more than 2 years).

Identify the pattern of concern: focused on a specific source of odor or multiple alternating sources. Assess frequent psychiatric comorbidities such as major depression, social anxiety, obsessive-compulsive disorder, and suicidal ideation, which may require additional codes.

Step 3: Differentiate from other codes

6B20 - Obsessive-compulsive disorder: The key difference lies in the content of obsessions. In OCD, obsessions may involve contamination, symmetry, forbidden thoughts, or need for order, with corresponding compulsions. In ORS (6B22), there is specific and persistent concern with emitting unpleasant odor. If a patient has obsessions about contamination AND concerns about body odor, but both are equally prominent, comorbid diagnoses may be considered.

6B21 - Body dysmorphic disorder: The key difference is that BDD involves concern with perceived defect in physical appearance (size, shape, symmetry), while ORS involves concern with odor. A patient may be concerned that their nose is large (BDD) or that they emit bad odor (ORS). If both concerns coexist, identify which is primary and most disabling. Occasionally, comorbid diagnoses are appropriate.

6B23 - Illness anxiety disorder: The key difference is that illness anxiety disorder involves concern with having or developing serious disease, with focus on physical health and medical consequences. In ORS, the focus is on social embarrassment from odor, not underlying disease. A patient with ORS may undergo medical examinations, but seeks confirmation about odor, not about serious disease.

Step 4: Required documentation

Adequate documentation should include:

Checklist of mandatory information:

• Detailed description of olfactory concern (type of odor, location, onset)
• Frequency and intensity of intrusive thoughts
• Specific repetitive behaviors (checking, camouflaging, reassurance-seeking)
• Concrete examples of ideas of reference
• Evidence of significant distress (scales, qualitative description)
• Documentation of functional impairment in specific domains (social, occupational, family)
• Results of medical evaluations that excluded organic causes
• Assessment of insight and degree of conviction
• Presence or absence of psychiatric comorbidities
• Total duration of symptoms
• Previous treatments and responses

The record should be sufficiently detailed to justify the diagnosis and guide therapeutic planning, but also allow another professional to clearly understand the clinical picture and the rationale for coding.

6. Complete Practical Example

Clinical Case

Initial presentation: Maria, 26 years old, elementary school teacher, was referred to the mental health service after multiple consultations in dermatology and gastroenterology over the past 18 months. She presents visibly anxious, maintaining physical distance during the interview and frequently covering her mouth while speaking.

Chief complaint: "My breath is horrible, people can smell it from far away and it's ruining my life." She reports that two years ago, following an episode of acute gastroenteritis, she began to notice that her breath had a "rotten sewage smell." Initially, she sought dental treatment, underwent professional cleanings, periodontal treatment, and extracted two teeth that she considered the "source of the problem," without improvement in her concerns.

Assessment performed: During detailed interview, Maria reports that she thinks about her breath "constantly, from the moment I wake up until I fall asleep." She has developed elaborate rituals: brushes her teeth 12-15 times per day (until her gums bleed), uses mouthwash every 30 minutes, avoids foods she believes worsen the odor (garlic, onion, meat, dairy products), and maintains an extremely restricted diet. She carries a bag containing a toothbrush, toothpaste, mouthwash, and breath spray, frequently absenting herself from classes to "check" her breath.

She reports prominent ideas of reference: "I see students covering their noses when I approach, parents comment among themselves about the smell, my colleagues avoid sitting near me in the cafeteria." When asked if anyone has directly commented on odor, she denies it, but states: "They don't need to speak, I see it in their reactions."

The functional impairment is marked: she requested medical leave from work, avoids social situations, ended a three-year romantic relationship ("it's not fair to subject someone to this"), stopped visiting family, and reports passive suicidal ideation ("sometimes I think it would be better not to exist than to live like this").

Previous medical evaluation included: dental consultation with normal findings, upper digestive endoscopy without alterations, objective halitosis test (halimeter) with normal results. Family members and close friends consistently deny perceiving any odor.

Diagnostic reasoning: The case presents the central elements of ORS: (1) persistent concern with odor (breath) that others do not perceive, (2) excessive distress and clear ideas of reference, (3) repetitive checking and camouflaging behaviors, (4) marked social avoidance, (5) significant suffering and severe functional impairment in multiple domains, (6) absence of objective medical cause for odor.

The duration of two years and progression with functional decline confirm that this is not a transient concern. The specific focus on odor (and not on physical appearance or illness) differentiates it from BDD and health anxiety. Although there are repetitive behaviors, these are specifically related to the perceived odor, not to other obsessive themes typical of OCD.

Step-by-Step Coding

Criteria analysis:

• ✓ Persistent concern with body odor/breath: PRESENT (constant thoughts about breath)
• ✓ Odor imperceptible or barely perceptible to others: CONFIRMED (objective assessments normal, denial by others)
• ✓ Excessive distress: PRESENT (intense suffering, social avoidance)
• ✓ Ideas of reference: PRESENT (interpretation of neutral behaviors as reactions to odor)
• ✓ Repetitive behaviors: PRESENT (excessive brushing, mouthwash use, checking)
• ✓ Significant suffering: PRESENT (suicidal ideation, isolation)
• ✓ Functional impairment: PRESENT (medical leave, loss of relationship, social isolation)

Code selected: 6B22 - Olfactory reference disorder

Complete justification: Code 6B22 is the most appropriate because the clinical presentation meets all diagnostic criteria established in ICD-11 for ORD. The central and persistent concern with breath, accompanied by excessive compensatory behaviors, ideas of reference, and marked functional impairment, precisely characterizes this disorder. The exclusion of medical causes through appropriate evaluations and the discrepancy between the patient's perception and objective assessments reinforce the diagnosis.

Complementary codes:

• [6A70.1](/en/code/6A70.1) - Moderate depressive episode (comorbidity, considering depressed mood, suicidal ideation, and social isolation)
• [MB23.1](/en/code/MB23.1) - Suicidal ideation (to document specific risk)

7. Related Codes and Differentiation

Within the Same Category

6B20: Obsessive-compulsive disorder

When to use vs. 6B22: Use 6B20 when the patient presents with obsessions (intrusive thoughts, images, or unwanted urges) on diverse themes such as contamination, symmetry, forbidden thoughts, or need for order, accompanied by compulsions (repetitive behaviors or mental acts) performed to reduce anxiety. Use 6B22 when the concern is specifically with emitting an unpleasant odor.

Main difference: In OCD (6B20), obsessions vary widely in content and compulsions may include checking, washing, counting, ordering, or mental rituals on diverse themes. In olfactory reference disorder (6B22), there is specific and focal concern with perceived body odor, with behaviors directed specifically at checking, camouflaging, or preventing odor. OCD is characterized by rituals that the patient recognizes as excessive; in olfactory reference disorder, behaviors are seen as a necessary response to a perceived real problem.

6B21: Body dysmorphic disorder

When to use vs. 6B22: Use 6B21 when the main concern involves perceived defect in physical appearance—size or shape of body parts, asymmetries, skin imperfections, facial features. Use 6B22 when the concern is with body odor, not appearance.

Main difference: BDD (6B21) focuses on how the body looks visually; olfactory reference disorder (6B22) focuses on how the body smells. In BDD, behaviors include mirror checking, comparison with others, camouflaging of body parts perceived as defective. In olfactory reference disorder, behaviors involve odor checking, excessive use of hygiene products, avoidance of physical proximity. Although both involve concern with bodily aspect and may coexist, the primary focus differs.

6B23: Illness anxiety disorder (Hypochondriasis)

When to use vs. 6B22: Use 6B23 when the patient is worried about having or developing serious illness, with focus on bodily symptoms interpreted as signs of serious disease. Use 6B22 when the concern is with social embarrassment caused by odor, not with underlying disease.

Main difference: In illness anxiety disorder (6B23), the central fear is of disease and its health consequences; patients seek medical evaluations to confirm or exclude feared diseases. In olfactory reference disorder (6B22), although patients may seek medical evaluations, the goal is to confirm/treat the odor, not diagnose serious disease. Distress in illness anxiety disorder comes from fear of being ill; in olfactory reference disorder, it comes from perceived social embarrassment.

Differential Diagnoses

Schizophrenia and other psychotic disorders: When olfactory concerns are part of a broader delusional system, with presence of hallucinations, disorganized thinking, or negative symptoms, consider diagnosis of schizophrenia spectrum disorder. The distinction lies in the presence of other psychotic symptoms and the degree of completely absent insight.

Delusional disorder: If the belief about body odor reaches delusional intensity (unshakeable conviction, bizarre, resistant to contradictory evidence) without other psychotic symptoms, somatic type delusional disorder may be considered. The line between olfactory reference disorder with poor insight and delusional disorder can be tenuous, requiring careful assessment of the degree of conviction.

Major depression with psychotic features: Somatic concerns, including about body odor, may occur during severe depressive episodes. If olfactory concerns arose exclusively during a depressive episode and remit with depression treatment, the primary diagnosis is depression.

Social phobia: Anxiety in social situations may include concern about bodily aspects, but in pure social phobia, there is no fixed conviction of actual odor. The patient fears negative evaluation in general, is not convinced of emitting specific odor.

8. Differences with ICD-10

In ICD-10, Olfactory Reference Disorder did not have its own specific code. Cases were frequently coded under different categories depending on the presentation and clinician's interpretation:

F45.2 - Hypochondriacal disorder: Many cases of ORD were classified here, although inadequately, since the focus in ICD-10 was on disease worry, not specifically on body odor.

F22.8 - Other persistent delusional disorders: Cases with very poor or absent insight sometimes received this code, especially when the conviction about the odor was unshakeable.

F42 - Obsessive-compulsive disorder: Some cases were coded as OCD due to repetitive checking and camouflaging behaviors.

F45.8 - Other somatoform disorders: Residual category frequently used when others did not fit perfectly.

The main change in ICD-11 is the formal recognition of ORD as a distinct diagnostic entity with a specific code (6B22), reflecting growing evidence that this condition has particular clinical characteristics, course, and treatment response. This specificity allows:

Practical impact of these changes:

1. Greater diagnostic precision: Clinicians can now specifically identify and code this condition, rather than using approximate categories.

2. Facilitation of research: Specific code allows more precise epidemiological studies, treatment research, and development of evidence-based clinical guidelines.

3. Validation of patient experience: Formal recognition reduces stigma and validates patient suffering, potentially encouraging appropriate treatment-seeking.

4. Resource allocation: Health systems can identify specific needs of this population and allocate resources for specialized services.

5. Improvement in clinical communication: Professionals from different specialties now share common nomenclature for this condition.

The transition from ICD-10 to ICD-11 represents a significant advance in the recognition and management of ORD, although it requires education of professionals about the specific criteria of the new code.

9. Frequently Asked Questions

How is Olfactory Reference Syndrome diagnosed?

The diagnosis is essentially clinical, based on a detailed interview that identifies the diagnostic criteria: persistent preoccupation with body odor that others do not perceive, ideas of reference, repetitive behaviors, and functional impairment. It is fundamental to perform appropriate medical evaluation to exclude organic causes of actual odor, such as dermatological, dental, gastrointestinal, or metabolic conditions. The evaluation may include physical examination, dental evaluation, and in selected cases, specific tests such as halimetry or evaluation for trimethylaminuria. The discrepancy between the patient's conviction and normal objective findings, combined with confirmation from family members or other observers that there is no perceptible odor, supports the diagnosis. Standardized assessment instruments may assist, but do not replace careful clinical evaluation.

Is treatment available in public health systems?

Treatment availability varies significantly among different health systems and regions. Evidence-based treatments for ORS include cognitive-behavioral therapy (CBT) adapted for this condition and selective serotonin reuptake inhibitor (SSRI) medications. Many public health systems offer access to mental health services that can provide these interventions, although there may be waiting lists. The availability of professionals specifically trained in ORS may be limited, but psychiatrists and psychologists with experience in obsessive-compulsive disorders can generally adapt therapeutic approaches. SSRI medications are widely available in essential medicine formularies in most public systems. Patients should seek mental health services in their area for specific information about availability and waiting times.

How long does treatment last?

Treatment duration varies considerably depending on symptom severity, presence of comorbidities, individual response, and therapeutic modality. For SSRI medication treatment, at least 12 weeks at an adequate dose is generally recommended to assess response, with maintenance treatment often necessary for 12-24 months or longer after symptom remission. Cognitive-behavioral therapy typically involves 16-20 weekly or biweekly sessions, with the possibility of periodic reinforcement sessions after completion of initial treatment. More severe cases or those with multiple comorbidities may require longer treatment. It is important to recognize that ORS often follows a chronic course with fluctuations, and some patients may require long-term maintenance treatment or recurrent treatment episodes. Premature discontinuation of treatment is associated with high relapse rates.

Can this code be used in medical certificates?

Yes, code 6B22 can and should be used in official medical documentation, including certificates, when appropriate. However, considerations regarding privacy and stigma are important. In certificates for occupational or educational purposes, one may choose to use more general terms such as "mental health disorder" or the higher category code "obsessive-compulsive or related disorders," unless specificity is necessary. For health insurance documentation, detailed medical reports, or communication between professionals, the specific code 6B22 should be used to ensure diagnostic accuracy and appropriate treatment. It is recommended to discuss with the patient what level of diagnostic detail to include in documents that will be shared with third parties, respecting privacy preferences whenever possible while maintaining the integrity of medical documentation.

What is the difference between ORS and normal hygiene concerns?

The fundamental distinction lies in intensity, persistence, and functional impact. Normal hygiene concerns are proportional, respond to reassurance, do not consume excessive time, and do not cause significant impairment. In ORS, the preoccupation is persistent and intrusive, occupying much of the day, resistant to reassurance (even when multiple people deny the odor, the conviction persists), accompanied by excessive behaviors that consume hours daily, and results in social avoidance, occupational impairment, or marked distress. Additionally, in ORS there are ideas of reference—interpretation of neutral behaviors of others as reactions to the perceived odor. If hygiene concerns do not significantly interfere with daily life, respond to contradictory evidence, and do not involve excessive rituals, they probably do not constitute a disorder.

Can ORS occur in children and adolescents?

Yes, although it is more commonly diagnosed in adolescents and young adults, with typical age of onset between 15-25 years. In younger children, the diagnosis should be made with caution, differentiating from developmentally normal concerns about social acceptance and hygiene. In adolescence, a period of greater self-consciousness and sensitivity to social evaluation, transient concerns about body odor are relatively common, especially with pubertal changes. The diagnosis of ORS in adolescents requires that symptoms be persistent (generally at least 6 months), cause disproportionate distress, and significantly interfere with school, social, or family functioning. Manifestations may include school refusal, peer isolation, excessive hygiene rituals, and family conflicts related to compulsive behaviors. Evaluation should consider developmental context and differentiate from other common disorders in this age group.

Do people with ORS have a higher suicide risk?

Yes, studies indicate that individuals with ORS present elevated rates of suicidal ideation and suicide attempts, comparable to or higher than other obsessive-compulsive and related disorders. Intense suffering, shame, social isolation, and hopelessness about the possibility of improvement contribute to increased risk. Factors that particularly elevate risk include: poor or absent insight (delusional conviction about the odor), comorbidity with major depression, history of previous attempts, severe social isolation, and absence of social support. It is fundamental that professionals systematically assess suicidal ideation and planning in all patients with ORS, especially during initial evaluation and periods of symptom exacerbation. Patients with active suicidal ideation or planning require urgent intervention and may need hospitalization. Appropriate treatment of ORS is associated with significant reduction in suicide risk.

Is ORS curable or is it a chronic condition?

The course of ORS is variable. Some patients experience complete remission with appropriate treatment, while others present a chronic course with fluctuations in symptom intensity. Factors associated with better prognosis include: recent symptom onset, good initial response to treatment, presence of some insight into the excessive nature of preoccupations, absence of severe psychiatric comorbidities, and good social support. Treatment combining medication (SSRI) and cognitive-behavioral therapy offers better response rates. Even when complete remission is not achieved, appropriate treatment often results in significant improvement in functioning and quality of life. It is important to establish realistic expectations: ORS generally requires prolonged treatment, and relapses may occur, especially if treatment is discontinued prematurely. A long-term management approach, similar to other chronic conditions, is often more appropriate than expectation of rapid definitive "cure."

---

Conclusion

Olfactory Reference Syndrome (code 6B22 in ICD-11) represents a specific and disabling psychiatric condition that requires appropriate recognition and specialized treatment. Correct coding is essential to ensure that patients receive appropriate interventions, facilitate research, and allow adequate allocation of health resources. Professionals should be familiar with the specific diagnostic criteria, differential diagnoses, and evidence-based therapeutic approaches for this frequently underdiagnosed condition.

External References

This article was developed based on reliable scientific sources:

1. 🌍 WHO ICD-11 - Olfactory Reference Disorder
2. 🔬 PubMed Research on Olfactory Reference Disorder
3. 🌍 WHO Health Topics
4. 📋 NICE Mental Health Guidelines
5. 📊 Clinical Evidence: Olfactory Reference Disorder
6. 📋 Ministry of Health - Brazil
7. 📊 Cochrane Systematic Reviews

References verified on 2026-02-03