Lim Leslie, Wan Yi Min
Clinical Associate Professor, National University of Singapore, Singapore, and; Senior Consultant, Department of Psychiatry, Singapore General Hospital, Singapore.
Associate Consultant, Department of Psychiatry, Ng Teng Fong General Hospital, Singapore
Australas Psychiatry. 2015 Jun;23(3):300-2. doi: 10.1177/1039856215579541. Epub 2015 Mar 30.
Jikoshu-kyofu (JKF), a condition characterised by a fear of offending others through emitting foul body odour, was first described in Japan in the 1960s. Although initially thought to be a culture-bound syndrome, it has been described in other countries. It is well established that there are two variants, a non- delusional and a delusional variant.
We describe two cases of JKF who sought treatment from a hospital in Singapore, compare and contrast their characteristics, and in view of overlaps with other conditions, discuss differential diagnoses.
Both cases involved women with fairly similar symptomatology except that the first case was younger, had overvalued ideas (but not delusions), an earlier age of onset and good treatment response, while the other had delusions, late age of onset, became too distressed to continue working and was initially resistant to treatment.
It appears that the delusional variant may have a longer symptomatic duration before presentation, poorer insight, more resistance to treatment and multiple physician consultations, as well as greater impairment of socio-occupational functioning in contrast to the non-delusional variant.
恐人症（JKF）是一种以害怕通过散发难闻体味冒犯他人为特征的病症，于20世纪60年代在日本首次被描述。尽管最初被认为是一种文化相关综合征，但在其他国家也有相关描述。目前已明确存在两种变体，即非妄想型和妄想型。
我们描述了两名在新加坡一家医院寻求治疗的JKF病例，比较并对比了她们的特征，鉴于其与其他病症存在重叠，讨论了鉴别诊断。
两例均为女性，症状相当相似，只是第一例患者年龄较小，有超价观念（但无妄想），起病年龄较早且治疗反应良好，而另一例有妄想，起病年龄较晚，痛苦到无法继续工作，且最初对治疗有抵触情绪。
与非妄想型变体相比，妄想型变体似乎在就诊前症状持续时间更长，洞察力更差，对治疗更具抵抗性且需多次就医，社会职业功能受损也更严重。
