Body integrity identity disorder (BIID): How satisfied are successful wannabes

Background: People suffering from Body Integrity Identity Disorder feel the intensive wish for an amputation of one limb or another kind of handicap. Due to ethic and juristic reasons, the desired surgery is difficult to realize. In spite of these problems several patients were able to achieve the wished amputation, in most cases with a cash-paid surgery in a less developed country. Our study examined whether these patients are sufficient with the amputation in the long run. Methods: We found 21 operated BIID-people (18 men, 3 woman; 27 73 years old, average 53.5 years) and interviewed them with a questionnaire. Here, we asked e.g. about quality of life and mental states before and after their surgery, the integration into the social environment, changes of their own dreams, the desire for further surgery and the presence of phantom sensations. Results: Psychological therapy, psychopharmacological medication, and relaxation techniques have had little effect and sometimes increased the desire. None of the patients regretted the surgery and a change for the better was seen in almost all areas of life. There were several problems regarding the quality of life, but they were estimated as bearable in contrast to the happiness to have fulfilled the wish. Many told their closer family members the true reasons of their amputation. Phantom limb feelings were reported, what contradicts the theory of BIID as a limb not embedded in the brain’s body-schema. After the operation most of the participants dreamed of themselves with an amputated body. The majority of the interviewee did not want further restrictions. Conclusions: These results point to the fact that the often assumed negative consequences of an amputation or further surgery do not occur. Thus, a realization of the wish of a person affected by BIID could be a possible form of therapy for patients, when other therapies have shown no effects.