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Rianne M Blom, Valeria Guglielmi, Damiaan Denys
Patients with body integrity identity disorder (BIID) experience a strong desire for amputation from very early on. BIID patients are often dismissed when they share their wish for amputation with surgeons. Consequently, patients resort to self-amputation, including complications and sometimes death. BIID patients are not psychotic and are mentally competent to oversee the consequences of an elective amputation. The authors offer arguments in favor of elective amputation.
September 13, 2016: CNS Spectrums
Rianne M Blom, Nienke C Vulink, Sija J van der Wal, Takashi Nakamae, Zhonglin Tan, Eske M Derks, Damiaan Denys
Body integrity identity disorder (BIID) is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only Western patients with BIID, suggesting that the disorder might be merely prevalent in the West. To scrutinize this assumption, and to extend our knowledge of the etiology of BIID, it is important to trace cases with BIID in non-Western populations...
2016: Neuropsychiatric Disease and Treatment
Daniele Romano, Anna Sedda, Peter Brugger, Gabriella Bottini
Individuals with the peculiar disturbance of 'overcompleteness' experience an intense desire to amputate one of their healthy limbs, describing a sense of disownership for it (Body Integrity Identity Disorder - BIID). This condition is similar to somatoparaphrenia, the acquired delusion that one's own limb belongs to someone else. In ten individuals with BIID, we measured skin conductance response to noxious stimuli, delivered to the accepted and non-accepted limb, touching the body part or simulating the contact (stimuli approach the body without contacting it), hypothesizing that these individuals have responses like somatoparaphrenic patients, who previously showed reduced pain anticipation, when the threat was directed to the disowned limb...
July 2015: Consciousness and Cognition
Amy White
In this article, I argue that persons suffering from Body Integrity Identity Disorder (BIID) can give informed consent to surgical measures designed to treat this disorder. This is true even if the surgery seems radical or irrational to most people. The decision to have surgery made by a BIID patient is not necessarily coerced, incompetent or uninformed. If surgery for BIID is offered, there should certainly be a screening process in place to insure informed consent. It is beyond the scope of this work, however, to define all the conditions that should be placed on the availability of surgery...
September 2014: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
S Oddo, J Möller, S Skoruppa, A Stirn
BACKGROUND: In BIID a disorder of body identity, concerned subjects desire an amputation of a healthy limb. So far, no psychiatric comorbidity was found in the few studies on BIID-subjects. PATIENTS AND METHODS: This study explored clinical symptoms, personality characteristics, interpersonal aspects and coping strategies in 15 BIID persons. Psychometric testing on the topics (1) clinical symptoms, (2) personality and interpersonal aspects, (3) coping strategies, (4) attitudes towards the body were used and statistically evaluated with the T-test for one sample...
May 2014: Fortschritte der Neurologie-Psychiatrie
Damiaan Denys
A recent article in the Dutch Journal of Medicine describes two cases of patients with body integrity identity disorder (BIID), a disorder in which patients might resort to self-amputation in order to create the body they wish for. The authors wonder if medical professionals should provide elective amputations in BIID patients in order to prevent them from harm and death. The amputation of a healthy limb in BIID in a medical context is currently under discussion. Doctors struggle to proceed to elective amputation of a healthy body part in BIID...
2014: Nederlands Tijdschrift Voor Geneeskunde
Rianne M Blom, Raoul C M Hennekam
BACKGROUND: Body integrity identity disorder (BIID) is a rare neuropsychiatric disorder in which patients experience a mismatch between the real and experienced body from childhood. BIID results in a strong desire to amputate or paralyse one or more limbs. CASE DESCRIPTION: We describe two BIID patients. A 40-year-old healthy male suffered daily from his desire for amputation, and therefore made a request for amputation at our academic medical centre. A 61-year-old male proceeded to self-amputation to create the body he had wished for, thereby curing himself from BIID...
2014: Nederlands Tijdschrift Voor Geneeskunde
Gabriella Bottini, Peter Brugger, Anna Sedda
Body integrity identity disorder (BIID) is characterized by the overwhelming desire to amputate one or more healthy limbs or to be paraplegic. Recently, a neurological explanation of this condition has been proposed, in part on the basis of findings that the insular cortex might present structural anomalies in these individuals. While these studies focused on body representation, much less is known about emotional processing. Importantly, emotional impairments have been found in psychiatric disorders, and a psychiatric etiology is still a valid alternative to purely neurological accounts of BIID...
2015: Neurocase
R M Blom, A W Braam, N de Boer-Kreeft, M P A M Sonnen
Body integrity identity disorder (BIID) is a rare condition in which a person, for no apparent physical reason, is tormented by the experience that a body-part, such as a limb, does not really belong to the body. Patients experience an intense desire for the limb to be amputated (a 'desire' formerly referred to as 'apotemnophilia'). We report on a 58-year-old male patient with BIID who froze one of his legs so that he could amputate it himself. A surgeon ultimately intervened and amputated the leg professionally...
2014: Tijdschrift Voor Psychiatrie
Milenna T van Dijk, Guido A van Wingen, Anouk van Lammeren, Rianne M Blom, Bart P de Kwaasteniet, H Steven Scholte, Damiaan Denys
Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs that do and do not feel as part of the body using functional MRI during separate tactile stimulation and motor execution experiments...
2013: PloS One
Peter Brugger, Bigna Lenggenhager, Melita J Giummarra
Xenomelia, the "foreign limb syndrome," is characterized by the non-acceptance of one or more of one's own extremities and the resulting desire for elective limb amputation or paralysis. Formerly labeled "body integrity identity disorder" (BIID), the condition was originally considered a psychological or psychiatric disorder, but a brain-centered Zeitgeist and a rapidly growing interest in the neural underpinnings of bodily self-consciousness has shifted the focus toward dysfunctional central nervous system circuits...
2013: Frontiers in Psychology
Rami Bou Khalil, Sami Richa
Apotemnophilia or body integrity identity disorder (BIID) denotes a syndrome in which a person is preoccupied with the desire to amputate a healthy limb. In this report, we review the available case reports in the literature in order to enhance psychiatrists' and physicians' comprehension of this disorder. A search for the case reports available via MEDLINE was done since the first case report published by Money et al in 1977 till May 2011, using the following terms: apotemnophilia, self-demand amputation, body integrity identity disorder, and BIID...
December 2012: International Journal of Lower Extremity Wounds
Rianne M Blom, Raoul C Hennekam, Damiaan Denys
INTRODUCTION: 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. METHODS: Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire...
2012: PloS One
Melita J Giummarra, John L Bradshaw, Leonie M Hilti, Michael E R Nicholls, Peter Brugger
BACKGROUND: Body incongruity in body integrity identity disorder (BIID) manifests in the desire to have a healthy limb amputated. We describe a variant of the disorder: the desire to become paralyzed (paralysis-BIID). METHOD: Sixteen otherwise healthy participants, recruited through Internet-based forums, websites, or word of mouth, completed questionnaires about details of their desire and accompanying symptoms. RESULTS: Onset of the desire for paralysis typically preceded puberty...
March 2012: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
Helena De Preester
Body integrity identity disorder (BIID), formerly also known as apotemnophilia, is characterized by a desire for amputation of a healthy limb and is claimed to straddle or to even blur the boundary between psychiatry and neurology. The neurological line of approach, however, is a recent one, and is accompanied or preceded by psychodynamical, behavioural, philosophical, and psychiatric approaches and hypotheses. Next to its confusing history in which the disorder itself has no fixed identity and could not be classified under a specific discipline, its sexual component has been an issue of unclarity and controversy, and its assessment a criterion for distinguishing BIID from apotemnophilia, a paraphilia...
May 2013: Medicine, Health Care, and Philosophy
Ilse Kryspin-Exner, Anna Felnhofer, Oswald D Kothgassner
The emersion of the Internet did not only change human communication and information seeking, it also contributed to manifold alterations in the manifestation, perception and treatment of mental disorders. Thus, one focus of current psychological research lies on the relationship between the new medium and psychosocial functioning. This review embraces recent results on this topic following a discussion from two different perspectives: first, it poses the question, whether the Internet - due to its very specific character - is capable of creating new mental disorders and second, it asks whether rare disorders may possibly be uncovered by the Internet or if already known disorders may be sustained and intensified by the online medium...
2011: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
Michael B First, Carl E Fisher
BACKGROUND: Body integrity identity disorder (BIID) is a rare and unusual psychiatric condition characterized by a persistent desire to acquire a physical disability (e.g., amputation, paraplegia) since childhood that to date has not been formally described in the psychiatric nosology. Most BIID sufferers experience a chronic and dysphoric sense of inappropriateness regarding their being able-bodied, and many have been driven to actualize their desired disability through surreptitious surgical or other more dangerous methods...
2012: Psychopathology
Melita J Giummarra, John L Bradshaw, Michael E R Nicholls, Leonie M Hilti, Peter Brugger
Body integrity identity disorder (BIID) is characterised by profound experience of incongruity between the biological and desired body structure. The condition manifests in "non-belonging" of body parts, and the subsequent desire to amputate, paralyse or disable a limb. Little is known about BIID; however, a neuropsychological model implicating right fronto-parietal and insular networks is emerging, with potential disruption to body representation. We argue that, as there is scant systematic research on BIID published to date and much of the research is methodologically weak, it is premature to assume that the only process underlying bodily experience that is compromised is body representation...
December 2011: Neuropsychology Review
Anna Sedda
Body Integrity Identity Disorder (BIID) is a condition in which individuals experience an intense desire for amputation of an healthy limb. Recently, McGeoch and colleagues provided the first direct evidence that this syndrome may be neurological rather than psychological in its origin. However, before including BIID in body ownership disorders, several concerns should be clarified, exploring other components of body representation and not only somatosensory perception.
December 2011: Neuropsychology Review
Aylin Thiel, Franziska J F Ehni, Silvia Oddo, Aglaja Stirn
OBJECTIVE: The Body Integrity Identity Disorder (BIID) is a fairly unknown and unexplored psychic illness. Very little cases underwent a psychotherapeutic treatment. METHODS: We report on the two-and-a-half year psychotherapy with a 37 years old man, who wants an amputation of his two legs. RESULTS: Origin and meaning of the amputation desire were uncovered in psychotherapy. CONCLUSIONS: The psychodynamic oriented therapy with cognitive-behavioral elements can be used to develop further treatment approaches...
July 2011: Psychiatrische Praxis
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