Body Integrity Identity Disorder

Rianne M Blom,Raoul C Hennekam,Damiaan Denys,Ben J Harrison

doi:10.1371/journal.pone.0034702

Abstract

IntroductionBody 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.MethodsSomatic, 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.ResultsBased 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.ConclusionsThe 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.

Highlights

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
The symptoms of BIID parallel those in somatoparaphrenia, a syndrome occurring secondary to right parietal lobe damage by a cerebral tumor or stroke
The present study aims to provide detailed phenomenology of BIID through the use of a detailed questionnaire given to a large group of BIID individuals

Summary

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. Body Integrity Identity Disorder (BIID) is a rare condition in which persons typically report an intense desire either to be paralyzed or to have one or more of their healthy limbs to be amputated [1,2,3]. The symptoms of BIID parallel those in somatoparaphrenia, a syndrome occurring secondary to right parietal lobe damage by a cerebral tumor or stroke. This similarity, coupled with the early onset, suggests that BIID could be a congenital disorder [7,8,9,10]

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Conclusion