Body Integrity Identity Disorder

Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
PLoS ONE (Impact Factor: 3.23). 04/2012; 7(4):e34702. DOI: 10.1371/journal.pone.0034702
Source: PubMed


Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID.
Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation) were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared.
Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification.
The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

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Available from: Damiaan Denys
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    • "Consensually, BIID is associated with the existence of a strong desire for a severe (physical) infirmity [3] [4]. The afflicted person believes to be " complete " only if realizing the amputation of a limb. "

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    • "Indeed, the risk of the arising of perceptual distortions of the body image could produce also detrimental effects due to the possible mismatch between the mental body image and the physical body. For example, psychological/psychiatric symptoms may occur, similar to those suffered by teens affected by body dysmorphic disorders, with consequent severe emotional distress, anxiety and depression or to those reported in the body integrity identity disorders or even somatoparaphrenia, where the subject reports extreme discomfort for a body segment that he feel as not belonging to him (Blom et al., 2012; Romano et al., 2014). "
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    • "The main phenomenological correlates of the different forms of xenomelia concern the erotic attraction to amputees or paraplegics and the urge to simulate the desired state. Paraphilic pre-occupation with the desired body modification is reported by 46–87% of samples in published accounts of xenomelia (First, 2005; Blom et al., 2012; Giummarra et al., 2012) and preferably targets amputation or paralysis of the legs. While sexual arousal is rarely the primary explanation of the desire to change one's own anatomy, it is worthy of attention with respect to the ontogeny and phenomenology of the condition. "
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