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The Desire for Healthy Limb Amputation: Psychiatric Features of Xenomelia

Published online by Cambridge University Press:  15 April 2020

B. Kraemer
Affiliation:
Kliniken für Psychiatrie Psychotherapie und Psychosomatik, Psychiatric Services Solothurn, Olten, Switzerland
L.M. Hilti
Affiliation:
Department of Neurology, University Hospital Zurich, Zurich, Switzerland
J. Hänggi
Affiliation:
Institut of Psychology/Division of Neuropsychology, University Hospital Zurich, Zurich, Switzerland
P. Brugger
Affiliation:
Department of Neurology, University Hospital Zurich, Zurich, Switzerland

Abstract

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Introduction

Xenomelia or Body Integrity Identity Disorder (BIID) is the oppressive feeling that one or more limbs of one’s body do not belong to one’s self. Some studies report absent comorbid psychiatric conditions, others point to abnormal psychological characteristics in BIID individuals.

Objectives

We carried out a study in order to shed light on theseinconsistent results. Unlike many previous investigations we examined each person individually in the frame of an extensive personal interview.

Methods

We examined 15 men with BIID and 15 pair-matched control subjects. Psychiatric and psychological assessment was performed using the SCID-Interview and various self-rating scales.

Results

The structured clinical interview did not produce any evidence for a psychotic disorder, but four BIID-participants werediagnosed with depressive disorder. The results of the self-rating scales did not reveal differences between participants with xenomelia and control participants with respect to body dysmorphic, obsessive-compulsive, schizotypal, depressive and anxiety symptoms. However, participants with xenomeliatended to be more impulsive (P = 0.07), and scored higher on borderline symptoms (P = 0.07) and dissociative symptoms (P = 0.08).

Conclusions

BIID is a rare, but dramatic and severe psychiatric condition. Individuals suffering from this disorder do not show major psychological or psychiatric problems and comorbidities. Suffering and depressive symptoms might be the result of the unfulfilled wish for an amputation and raise important ethical and medico-legal issues about the amputation of healthy limbs.

Type
Article: 0821
Copyright
Copyright © European Psychiatric Association 2015
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