Document Detail


Desire for amputation of a limb: paraphilia, psychosis, or a new type of identity disorder.
MedLine Citation:
PMID:  15997612     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The objective of this paper is to describe and conceptualize an unusual and probably rare condition: the intense longstanding desire to have an amputation. METHOD: Structured interviews were conducted by telephone of 52 subjects (mean age: 48.6, range 23-77 years; 47 male, 4 female, 1 intersexed) self-identified as having had a desire to have an amputation. RESULTS: Seventeen per cent (n = 9) had an arm or leg amputated with two-thirds using methods that put the subject at risk of death and one-third enlisting a surgeon to amputate their healthy limb. The most common reported reason for wanting an amputation was the subject's feeling that it would correct a mismatch between the person's anatomy and sense of his or her 'true' self (identity). None were delusional. For all but one subject age at onset was during childhood or early adolescence. For those who had psychotherapy or medication there was no change in the intensity of the desire for amputation. The six subjects who had an amputation at their desired site reported that following the amputation they felt better than they ever had and no longer had a desire for an amputation. CONCLUSIONS: These preliminary results suggest the existence of an extremely unusual clinically distinct condition characterized by a lifelong desire to have an amputation of a particular limb. The condition is associated with serious negative consequences: amputation attempts, impairment and marked distress. Reflecting similarities between Gender Identity Disorder and this condition, the author suggests that it may be conceptualized as an unusual dysfunction in the development one's fundamental sense of anatomical (body) identity.
Authors:
Michael B First
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Psychological medicine     Volume:  35     ISSN:  0033-2917     ISO Abbreviation:  Psychol Med     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-07-06     Completed Date:  2005-10-20     Revised Date:  2008-03-06    
Medline Journal Info:
Nlm Unique ID:  1254142     Medline TA:  Psychol Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  919-28     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA. mbf2@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amputation*
Body Image*
Extremities*
Female
Fetishism (Psychiatric)
Humans
Male
Middle Aged
Paraphilias / complications*,  psychology*
Personality Disorders / complications*,  diagnosis,  psychology*
Psychotic Disorders / complications*,  diagnosis,  psychology*
Social Identification*
Comments/Corrections
Comment In:
Psychol Med. 2007 Oct;37(10):1513; author reply 1513-4   [PMID:  18293510 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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