Skip to main content Accesibility Help

Neuropsychological Characteristics Associated with Olfactory Hallucinations in Schizophrenia

  • Deborah Arguedas (a1) (a2), Robyn Langdon (a2) and Richard Stevenson (a1)

Olfactory hallucinations (OHs) are present in a significant minority of people with schizophrenia, yet these symptoms are under-researched and poorly understood. This study aimed to identify the neuropsychological impairments that associate with OHs in schizophrenia. Patients with schizophrenia or schizoaffective disorder were classified into an OH group and a group with auditory-verbal hallucinations (AVHs) and no lifetime history of OHs. Patients were age- and gender-matched to a healthy control group. All participants were assessed using: a test of odor identification; decision-making and socio-emotional tests of orbitofrontal cortex (OFC) and amygdala function; and a battery of standardized executive tests. Patients, as a whole, performed more poorly than controls on the tests of odor identification, emotion processing and executive function, consistent with previous research. Only two tests of OFC functioning: the Object Alternation Task, taken from Oscar-Berman and Zola-Morgan's (1980a, 1980b) Comparative Neuropsychological Tasks, and a test of “faux pas” understanding discriminated between the OH and AVH patients. Findings provide the first preliminary support for OH-specific neuropsychological impairments associated with OFC dysfunction in schizophrenia. (JINS, 2012, 18, 1–10)

Corresponding author
Correspondence and reprint requests to: Robyn Langdon, ARC Centre of Excellence in Cognition and Its Disorders, Department of Cognitive Science, Macquarie University, Sydney, NSW 2019, Australia. E-mail:
Hide All
Acharya, V., Acharya, J., Luders, H. (1998). Olfactory epileptic auras. Neurology, 51, 5661.
Adolphs, R., Baren-Cohen, S., Tranel, D. (2002). Impaired recognition of social emotions following amygdale damage. Journal of Cognitive Neuroscience, 14, 12641274.
Adolphs, R., Tranel, D. (2003). Amygdala damage impairs emotion recognition from scenes only when they contain facial expressions. Neuropsychologia, 41, 12811289.
Andreasen, N.G. (1984a). Scale for the assessment of negative symptoms (SANS). Iowa City: University of Iowa Press.
Andreasen, N.G. (1984b). Scale for the assessment of positive symptoms (SAPS). Iowa City: University of Iowa Press.
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., Plumb, I. (2001). The “Reading the mind in the eyes” Test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42, 241251.
Bell, E.M., Langdon, R., Siegert, R.J., Ellis, P.M. (2010). The assessment of Theory of Mind in schizophrenia. In G. Dimaggio & P.H. Lysaker (Eds.), Metacognition and severe adult mental disorders: From research to treatment (pp. 115–133). London: Routledge Press.
Blumenfeld, H. (2002). Neuroanatomy through clinical cases. Sunderland, MA: Sinauer Associates, Inc.
Bora, E., Yucel, M., Pantelis, C. (2009). Theory of mind impairment in schizophrenia: Meta-analysis. Schizophrenia Research, 109, 19.
Carmichael, S.T., Clugnet, M.C., Price, J.J. (1994). Central olfactory connections in macaque monkeys. Journal of Comparative Neurology, 346, 403434.
Castle, D.J., Jablensky, A., McGrath, J.J., Carr, V., Morgan, V., Waterreus, A., Farmer, A. (2006). The diagnostic interview for psychoses (DIP): Development, reliability and applications. Psychological Medicine, 36, 6980.
Chen, C., Shih, Y.-H., Yen, D.-J., Lirng, J.-F., Guo, Y.-C., Yu, H.-Y., Yiu, C.-H. (2003). Olfactory auras in patients with temporal lobe epilepsy. Epilepsia, 44, 257260.
Chitanondh, H. (1966). Sterotaxic amygdalotomy in the treatment of olfactory seizures and psychiatric disorders with olfactory hallucinations. Confinia Neurologica, 27, 181196.
Crowder, R.G., Schab, F.R. (1995). Imagery for odors. In F.R. Schab & R.G. Crowder (Eds.), Memory for odors (pp. 93–107). Mahwah, NJ: L Erlbaum Associates.
Delisi, L.E. (1992). The significance of age of onset for schizophrenia. Schizophrenia Bulletin, 18, 209215.
Doty, R.L. (1989). The Smell Identification Test Administration Manual. Haddon Heights, NJ: Sensonics Inc.
Edwards, J., Jackson, H.J., Pattison, P.E. (2002). Emotion recognition via facial expression and affective prosody in schizophrenia: A methodological review. Clinical Psychology Review, 22, 789832.
Ekman, P., Friesen, W.V. (1976). Pictures of facial affect. Palo Alto, CA: Consulting Psychologists Press.
First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B.W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P, Version 2.0). New York: New York State Psychiatric Institute, Biometrics Research Department.
Freedman, M. (1990). Object alternation and orbitofrontal system in Alzheimer's and Parkinson's disease. Brain and Cognition, 14, 134143.
Freedman, M., Black, S., Ebert, P., Binns, M. (1998). Orbitofrontal function, object, alternation and perseveration. Cerebral Cortex, 8(1), 1827.
Fuller, G.N., Guiloff, R.J. (1987). Migrainous olfactory hallucinations. Journal of Neurology, Neurosurgery, and Psychiatry, 50, 16881690.
Gogtay, N., Vyas, N.S., Testa, R., Wood, S.J., Pantelis, C. (2011). Age of onset of schizophrenia: Perspectives from structural neuroimaging studies. Schizophrenia Bulletin, 37, 504513.
Gallagher, S., Frith, C.D. (2003). “Functional imaging of ‘theory of mind’”. Trends in Cognitive Sciences, 7, 7783.
Gellermann, L.W. (1933). Chance orders of alternating stimuli in visual discrimination tasks. Journal of Genetic Psychology, 42, 206208.
Green, M.J., Williams, L.M., Davidson, D. (2003). Visual scanpaths to threat-related faces in deluded schizophrenia. Psychiatry Research, 119, 271285.
Gregory, C., Lough, S., Stone, V., Erzinclioglu, S., Martin, L., Baron-Cohen, S., Hodges, J.R. (2002). Theory of mind in patients with frontal variant frontotemporal dementia and Alzheimer's disease: Theoretical and practical implications. Brain, 125, 752764.
Hawkes, C.H., Doty, R.L. (2009). The neurology of olfaction. Cambridge, UK: Cambridge University Press.
Heinrichs, R., Zakzanis, K.K. (1998). Neurocognitive deficit in schizophrenia: A quantitative review of the evidence. Neuropsychology, 12(3), 426445.
Herz, R.S. (2000). Verbal coding in olfactory versus nonolfactory cognition. Memory and Cognition, 28, 957964.
Kay, S.R., Opler, L.A., Spitzer, R.L., Williams, J.B.W., Fiszbein, A., Gorelick, A. (1991). SCIDPANSS: Two-tier diagnostic system for psychotic disorders. Comprehensive Psychiatry, 32, 355361.
Kang, N., Baum, M.J., Cherry, J.A. (2009). A direct main olfactory bulb projection to the ‘vomeronasal’ amygdale in female mice selectively responds to volatile pheromones from males. European Journal of Neuroscience, 29, 624634.
Kohler, C., Brennan, A. (2004). Recognition of facial emotions in schizophrenia. Current Opinion in Psychiatry, 17, 8186.
Kopala, L.C., Good, K.P., Honer, W.G. (1994). Olfactory hallucinations and olfactory identification ability in patients with schizophrenia and other psychiatric disorders. Schizophrenia Research, 12(3), 205211.
Kwapil, T.R., Chapman, J.P., Chapman, L.J., Miller, M.B. (1996). Deviant olfactory experiences as indicators of risk for psychosis. Schizophrenia Bulletin, 22, 371382.
Langdon, R. (2005). Theory of mind in schizophrenia. In B. Malle & S. Hodges (Eds.), Other minds; How humans bridge the divide between self and others (pp. 323–342). New York: Guilford Press.
Langdon, R., Coltheart, M., Ward, P.B. (2006). Empathetic perspective-taking is impaired in schizophrenia: Evidence from a study of emotion attribution & theory of mind. Cognitive Neuropsychiatry, 11(2), 133155.
Langdon, R., Coltheart, M., Ward, P.B. (2010). Reasoning anomalies associated with delusions in schizophrenia. Schizophrenia Bulletin, 36, 321330.
Langdon, R., McGuire, J., Stevenson, R., Catts, S.V. (2011). Clinical correlates of olfactory hallucinations in schizophrenia. British Journal of Clinical Psychology, 50, 145163.
Lewandowski, K.E., DePaola, J., Camsari, G.B., Cohen, B.M., Öngür, D. (2009). Tactile, olfactory, and gustatory hallucinations in psychotic disorders: A descriptive study. Annals of the Academy of Medicine, Singapore, 38, 383387.
Meats, P. (1988). Olfactory hallucinations. British Medical Journal, 296, 645.
Miyamichi, K., Amat, F., Moussavi, F., Wang, C., Wickersham, I., Wall, N.R., Luo, L. (2011). Cortical representations of olfactory input by trans-synaptic tracing. Nature, 472, 191196.
Oscar-Berman, M., Bardenhagen, F. (1998). Nonhuman animal models of memory dysfunction in neurodegenerative disease (pp. 3–20). NY: Cambridge University Press.
Oscar-Berman, M., Zola-Morgan, S.M. (1980a). Comparative neuropsychology and Korsakoff's Syndrome I-spatial and visual reversal learning. Neuropsychologia, 18, 499512.
Oscar-Berman, M., Zola-Morgan, S.M. (1980b). Comparative neuropsychology and Korsakoff's Syndrome II-two-choice visual discrimination learning. Neuropsychologia, 18, 513525.
Pantelis, C., Brewer, W. (1995). Neuropsychological and olfactory dysfunction in schizophrenia: Relationship of frontal syndromes to syndromes of schizophrenia. Schizophrenia Research, 17(1), 3545.
Pantelis, C., Yucel, M., Wood, S.J., Velakoulis, D., Sun, D., Berger, G., McGorry, P.D. (2005). Structural brain imaging evidence for multiple pathological processes at different stages of brain development in schizophrenia. Schizophrenia Bulletin, 31, 672696.
Reichenberg, A., Harvey, P.D. (2007). Neuropsychological impairments in schizophrenia: Integration of performance-based and brain imaging findings. Psychological Bulletin, 133(5), 833858.
Saoud, M., Hueber, T., Mandran, H., Dalery, J., d'Amato, T. (1998). Olfactory identification deficiency and WCST performance in men with schizophrenia. Psychiatry Research, 81(2), 251257.
Saxe, R., Kanwisher, N. (2003). People thinking about thinking people: The role of the temporo-parietal junction in “theory of mind”. Neuroimage, 19, 18351842.
Schreiber, A., Calvert, P.C. (1986). Migrainous olfactory hallucinations. Headache, 26, 513514.
Seal, M.L., Aleman, A., McGuire, P. (2004). Compelling imagery, unanticipated speech and deceptive memory: Neurocognitive models of auditory verbal hallucinations in schizophrenia. Cognitive Neuropsychiatry, 9(1/2), 4372.
Seidman, L.J., Oscar-Berman, M., Kalinowski, A.G., Ajilore, O., Kremen, W.S., Faraone, S.V., Tsuang, M.T. (1995). Experimental and clinical neuropsychological measures of prefrontal dysfunction in schizophrenia. Neuropsychology, 9(4), 481490.
Shenton, M.E., Dickey, C.C., Frumin, M., McCarley, R.W. (2001). A review of MRI findings in schizophrenia. Schizophrenia Research, 49, 152.
Shaw, P., Bramham, J., Lawrence, E.J., Morris, R., Baron-Cohen, S., David, A.S. (2005). Differential effects of lesions of the amygdala and prefrontal cortex on recognizing facial expressions of complex emotions. Journal of Cognitive Neuroscience, 17, 14101419.
Stedman, T.J., Clair, A.L. (1998). Neuropsychological, neurological and symptom correlates of impaired olfactory identification in schizophrenia. Schizophrenia Research, 32(1), 2330.
Stevenson, R., Langdon, R., McGuire, J. (2011). Olfactory hallucinations in schizophrenia and schizoaffective disorder: A phenomenological survey. Psychiatry Research, 185, 321327.
Stone, V.E., Baron-Cohen, S., Calder, A., Keane, J., Young, A. (2003). Acquired theory of mind impairments in individuals with bilateral amygdala lesions. Neuropsychologia, 41(2), 209220.
Stone, V.E., Baron-Cohen, S., Knight, R.T. (1998). Frontal lobe contributions to theory of mind. Journal of Cognitive Neuroscience, 10(5), 640656.
Torralva, T., Kipps, C.M., Hodges, J.R., Clark, L., Bekinschtein, T., Roca, M., Manes, F. (2007). The relationship between affective decision-making and theory of mind in the frontal variant of fronto-temporal dementia. Neuropsychologia, 45, 342349.
Velakoulis, D. (2006). Olfactory hallucinations. In W.J. Brewer, D. Castle, C. Pantelis (Eds.), Olfaction and the brain (pp. 322–333). Melbourne: CUP.
Wechsler, D. (2001). Wechsler Test of Adult Reading. USA: Psychological Corporation.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed