Body Integrity Identity Disorder

Under Body Integrity Identity Disorder ( German: body integrity identity disorder), short form BIID, understands the desire of a man, his body or mind altering. Frequently it is desired then, with one or more limbs of living less. Other types of physical reduction can be expressed as a wish.

A related phenomenon is the Xenomelie, " the oppressive feeling that one or more members of one's body does not belong to one's own self. "

Symptoms

Affected feel that their body or a body function should be changed, in a form that is viewed from the outside as a disability.

The often overwhelming desire to amputate one or more limbs, or to sever the spinal cord or a different function ( hearing, vision ) is experienced cancel and thus the real body in accordance with the "right " can actually paraplegia, deafness, blindness, etc. bring. Some sufferers bind, for example, her arm on the back, because they perceive it as annoying.

People with BIID however, it is very difficult to realize their desires, by one by physicians surgery. This resulted in those affected often life-threatening self-help, for example by hypothermia with Nekrosefolgen, firearms and similar instruments or by staged accidents.

Persons living with BIID, describe themselves as partly self- Wannabe (of English want to be. Want to be something, " wannabe "). Many sufferers try to gain relief by using prostheses, orthoses, wheelchairs or white canes with which a distant experience of the desired physical impairment is generated. This audition a non-existent state is also called Pretending.

Since not only the desire for amputation is present, but rather the need to adapt his real body the disturbed body image, Michael First established the term " Body Integrity Identity Disorder ". The disorder has not yet found a way into the Diagnostic and Statistical Manual of Mental Disorders. However, you went to the DSM Task Force, which has proposed to include them in a new area, which includes unexplored or very rare diseases. The inclusion in the next version of International Statistical Classification of Diseases and Related Health Problems was rejected. This was due to the small number of interested parties, the fact that " BIID " is not listed in the DSM as a disease, and the controversial issue of whether the desire for a voluntary amputation can be understood as a disease.

Causes

The causes of BIID are unknown. It discusses both neuroanatomical changes of functional brain regions and developmental approaches, according to which already established a disorder of the body schema in childhood. For both interpretations, the fact that it is possible to demonstrate a history of a manifestation of the disease in early adolescence in the majority of people with BIID.

Therapy

Whether such a body change requests can be considered as a disease, is currently controversial.

A causal treatment is currently unknown. It can be tried with psychiatric and behavioral therapeutic support to achieve stabilization of the state. However, no treatment cases have been reported from the psychotherapeutic practice in the last 30 years. The administration of selective serotonin reuptake inhibitors can be performed as adjunctive antidepressant therapy. It is currently believed that a cure for the purposes of the disappearance of suffering only by the amputation itself is possible.

The Scottish physician Robert Smith has made two leg amputations in patients with BIID in 2000. By indiscretions and after a report by the BBC television forbade the British Medical Association as requested by the Scottish National Parliament further amputations. The reason given was that the public would disapprove of such interventions; In addition, a rush of foreign BIID - affected was feared.