False body odour belief signals mental illness

Qn: “Is body odour triggered by the mental state of an individual. A motivational speaker once claimed so”

Many years ago, a woman was sent to us by her doctor because “she thinks she has a bad smell emanating from her body”.

The referral letter went on to explain that the lady was very distressed because her husband of many years was pretending not to experience the smell, but she was sure he was telling lies. A pastor who she visited made the situation worse for her when he said he was not sure if the smell was there or not because he had a cold. She “knew” he was also telling lies.

When she saw her doctor, he agreed to do a number of tests, “just to be sure”. He, however, said he could not detect the foul odor, possibly because of the hospital smell of surgical spirit. The hunt for the source of the bad smell was on. First with Ear, Nose and Throat (ENT) surgeons, who checked on tonsils, sinuses and ears. No smell, no cause of smell. Then came gastroenterology people who looked for all possible bacteria from the GIT (Gastrointestinal Tract). She was not even belching. Skin doctors, gynecologists and all other experts found neither smell nor any disease.

When we saw her she was in great distress. She knew that she had a smell and “all these people were merely pretending”. She knew it was there because sometimes in church, or in buses she saw a person here or there touch his nose. She also was sure that people in the street often cross to the other side because of the smell she emits. Once, she entered a shop and a woman she did not know walked out! She was sure that the woman had walked out because of the smell.

Other than the claim that she emitted a bad smell, the woman was physically well, was doing well in business and served the community well. She seemed healthy in all respects other than this most disturbing body odor.

The diagnosis we made has a fancy name; “Monosymptomatic Delusional disorder”. This simply means that the woman had a false belief (about the smell) that evidence could not shift. In other words, she did not believe her husband or her children when they told her she had no smell. The doctors who examined her were also “missing something” or were like her family, just being nice to her. No amount of reasoning would shift this false belief.

After consulting other colleagues and with the consent of the family it was agreed that this woman had a delusional disorder and that she would benefit from treatment of the mental illness. Tablets and injections were ordered and she said she was prepared to do anything to get rid of the smell.

A few weeks later, she returned to church, went to women’s meetings and started to invite friends and family to her home. The medication had, in her view, taken away the smell she was emitting. The antipsychotic medication had melted the delusion away.

A man with a condition similar to her had the delusions of poverty. He was a wealthy man who was well invested. He was sent to a psychiatrist when he refused to eat or sleep in his home because he was too poor to lead such a fancy life!

His bank statements were in his view, forged or bore his name by mistake. He believed he was poor and could not eat expensive things like meat and fruits. His was a delusion of poverty and was treated with much success using similar medicines. Some severally depressed people have very similar delusions.

In yet another case, a middle aged man believed that there were parasites in his digestive system. No amount of stool tests, X-Rays and endoscopies would convince him that he had no parasites.

The more the doctors looked, the more he was convinced they were missing something. His trips overseas failed to find the parasites. He also got better on antipsychotic medication.

By definition, a motivational speaker is a speaker who makes speeches intended to motivate or inspire an audience. I am not aware of any college or university that offers degrees in motivational speaking. I am forced to conclude that one becomes a motivational speaker by an act of self-declaration.

It is possible that the motivational speaker you listened to did not have a qualification in mental health but was motivated to speak on a subject he knew little or nothing about. It was clearly memorable for you. The simple truth is that some mental health disorders can lead to a false belief about body odour.