Letters To The Editor Open Access
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Sep 20, 2018; 8(3): 105-107
Published online Sep 20, 2018. doi: 10.5498/wjp.v8.i3.105
Psychic euosmia and obsessive compulsive personality disorder
Massimo Pasquini, Annalisa Maraone, Valentina Roselli, Lorenzo Tarsitani
Massimo Pasquini, Annalisa Maraone, Department of Human Neurosciences, Sapienza University, Rome 00185, Italy
Valentina Roselli, Lorenzo Tarsitani, Department of Neurosciences and Mental Health, Umberto I General Hospital, Rome 00185, Italy
ORCID number: Massimo Pasquini (0000-0003-3959-8137); Annalisa Maraone (0000-0003-2390-4494); Valentina Roselli (0000-0001-8151-2910); Lorenzo Tarsitani (0000-0002-1752-966X).
Author contributions: All the authors contributed to the conceptualization and the drafting of the paper and they critically reviewed the manuscript.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Massimo Pasquini, MD, PhD, Associate Professor, Department of Human Neurosciences, Sapienza University, viale dell’Università 30, Rome 00185, Italy. massimo.pasquini@uniroma1.it
Telephone: +39-64-9914121 Fax: +39-64-9914591
Received: March 5, 2018
Peer-review started: March 8, 2018
First decision: March 30, 2018
Revised: April 11, 2018
Accepted: May 30, 2018
Article in press: May 30, 2018
Published online: September 20, 2018

Abstract

Patients with obsessive compulsive personality disorder (OCPD) often refer to a prompt mood improvement upon encountering good scents in general, or fresh laundry borax on their clothes, pillows or home settings. The Authors propose the new term psychic euosmia in the mean of an overstated psychological predisposition for a real pleasant smell that elicits an immediate sense of pleasure, order and calm. The prompt reactions to a pleasant odor might be explained by the involvement of rhinencephalon and its proximity to mood-related limbic circuits, which bypass the cognitive awareness. Cleanliness may not preclude a subject to enjoy a good smell, even if we are representing smells that resemble freshness, in other words order. A potentially even more important argument is given by the continuum of personality disorders and their variability. Not all personality characteristics led to disturbed behaviors. In evolutionary perspectives having the ability to differentiate between unpleasant and pleasant odors should have made the difference in surviving. On the other hand, psychic euosmia could be considered a normal reaction, but in our clinical experience it is over-represented among OCPD subjects with marked orderliness and disgust. Therefore, detecting psychic euosmia might vicariously confirm the relevance of disgust as a cognitive driver of OCPD. Hereby we support research to characterize psychic euosmia as a feature of orderliness and cleanliness for OCPD.

Key Words: Psychic euosmia, Obsessive compulsive personality disorder, Orderliness, Pleasure, Positive emotion, Pesonality

Core tip: Patients with obsessive compulsive personality disorder (OCPD) often refer to a prompt mood improvement upon encountering good scents in general, or fresh laundry borax on their clothes, pillows or home settings. The Authors propose the new term psychic euosmia in the mean of an overstated psychological predisposition for a real pleasant smell that elicits an immediate sense of pleasure, order and calm. Detecting psychic euosmia might vicariously confirm the relevance of disgust as a cognitive driver of OCPD. Hereby we support research to characterize psychic euosmia as a feature of orderliness and cleanliness for OCPD.



TO THE EDITOR

Pierre Janet, in his conceptualization of obsessions and compulsions, described an inability to achieve perfection[1]. This phenomenon characterizes both obsessive compulsive personality disorders (OCPD) and OCD. Available literature indicates that two main factors of OCPD, order/control and hoarding/indecision, were identified among OCPD patients[2]. Hyper-control and orderliness, cleanliness other than perfectionism are often awkward and dysfunctional in these subjects. Yet, OCPD manifestations are generally considered ego-syntonic and are perceived by affected individuals as appropriate and correct. In many OCPD subjects perfectionism does not represent a maladaptive variant as a rule. In any case, there are several effects of orderliness behaviors that result in an underrated emotion of pleasure, even thought subjects are aware of its pathological nature. This is the case of a peculiar manifestation of orderliness. Clinicians involved in the treatment of OCPD are aware of how their patients often refer to a prompt mood improvement upon encountering good scents in general, or fresh laundry borax on their clothes, pillows or home settings. In medical terminology parosmia is defined as an olfactory dysfunction to properly identify an odor’s “natural” smell, while euosmia is a form of parosmia in which a neutral odor is transcribed into a pleasant odor. Here we refer to psychic euosmia in the mean of an overstated psychological predisposition for a real pleasant (not neutral) smell that elicits an immediate sense of pleasure, order and calm. It could be seen as the opposite reaction of irritability of sensory experiences called misophonia[3]. For OCPD patients, congenial odors resemble a sensation of freshness, not simply an essence or perfume.

Some may argue that this is exactly the counterpart of chaos, of disgust, that was associated to contamination and moral purity. Disgust-sensitivity is a well-know framework in cognitive models of OCD, but it fits to OCPD too, perhaps better. From a biological perspective unpleasant odors activate insula and caudate[4]. More, enlarged gray matter volume of the left medial orbital gyrus was found by using the Sniffin’ Sticks test[5]. The prompt reactions to a pleasant odor might be explained by the involvement of rhinencephalon and its proximity to mood-related limbic circuits, which bypass the cognitive awareness.

To our knowledge there are no studies regarding neurobiological abnormalities or clinical aspects that investigate the correlates of psychic euosmia in OCD and OCPD subjects. As an explanation in mental health, researchers and clinicians are automatically looking at pathological aspects of phenomena. In his nonconforming paper Bentall stressed that psychopathologists tautologically are not concerned about elation and joy[6] Hence we posit that a pathological issue, as an overrepresented psychic euosmia, should not have a positive emotional consequence in reason of being pathological per se. Thus, cleanliness may not preclude a subject to enjoy a good smell, even if we are representing smells that resemble freshness, in other words order. A potentially even more important argument is given by the continuum of personality disorders and their variability. Not all personality characteristics led to disturbed behaviors. In this way, having OCPD traits could be not dysfunctional at all, and many individuals with OCPD traits deal with head positions in their activities. In evolutionary perspectives having the ability to differentiate between unpleasant and pleasant odors should have made the difference in surviving[7]. On the other hand, psychic euosmia could be considered a normal reaction, but in our clinical experience it is over-represented among OCPD subjects with marked orderliness and disgust. Therefore, detecting psychic euosmia might vicariously confirm the relevance of disgust as a cognitive driver of OCPD. Hereby we support research to characterize psychic euosmia as a feature of orderliness and cleanliness for OCPD.

Footnotes

Manuscript source: Unsolicited Manuscript

Specialty type: Psychiatry

Country of origin: Italy

Peer-review report classification

Grade A (Excellent): 0

Grade B (Very good): 0

Grade C (Good): C

Grade D (Fair): 0

Grade E (Poor): 0

P- Reviewer: Chakrabarti S S- Editor: Ji FF L- Editor: A E- Editor: Bian YN

References
1.  Janet P. Les obsessions et la psychasthénie. Revue Philosophique De La France Et De Létranger. 1903;56:293-312.  [PubMed]  [DOI]  [Cited in This Article: ]
2.  Riddle MA, Maher BS, Wang Y, Grados M, Bienvenu OJ, Goes FS, Cullen B, Murphy DL, Rauch SL, Greenberg BD. Obsessive-compulsive personality disorder: Evidence for two dimensions. Depress Anxiety. 2016;33:128-135.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 15]  [Cited by in F6Publishing: 7]  [Article Influence: 2.5]  [Reference Citation Analysis (0)]
3.  Dozier TH, Lopez M, Pearson C. Proposed Diagnostic Criteria for Misophonia: A Multisensory Conditioned Aversive Reflex Disorder. Front Psychol. 2017;8:1975.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 19]  [Cited by in F6Publishing: 11]  [Article Influence: 4.8]  [Reference Citation Analysis (0)]
4.  Berlin HA, Stern ER, Ng J, Zhang S, Rosenthal D, Turetzky R, Tang C, Goodman W. Altered olfactory processing and increased insula activity in patients with obsessive-compulsive disorder: An fMRI study. Psychiatry Res Neuroimaging. 2017;262:15-24.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 15]  [Cited by in F6Publishing: 11]  [Article Influence: 3.8]  [Reference Citation Analysis (0)]
5.  Segalàs C, Alonso P, Orbegozo A, Real E, Subirà M, López-Solà C, Martínez-Zalacaín I, Labad J, Harrison BJ, Pujol J. Brain structural imaging correlates of olfactory dysfunction in obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci. 2014;264:225-233.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 10]  [Cited by in F6Publishing: 7]  [Article Influence: 1.3]  [Reference Citation Analysis (0)]
6.  Bentall RP. A proposal to classify happiness as a psychiatric disorder. J Med Ethics. 1992;18:94-98.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 7]  [Cited by in F6Publishing: 1]  [Article Influence: 0.2]  [Reference Citation Analysis (0)]
7.  Darwin CR; The Expression of Emotions in Man and Animals. 1st edition. London: John Murray. 1872;.  [PubMed]  [DOI]  [Cited in This Article: ]