Body Integrity Identity Disorder (BIID): What do health care professionals know?

Dorothée Neff, Erich Kasten


Body Integrity Identity Disorder (BIID) is a syndrome in which people have the intense feeling their body will be "more complete" after the amputation of a limb. In spite of the broad reporting in the yellow press, most of the BIID affected patients we have investigated in the last few years told us they were nearly always confronted with a lack of professional knowledge when they sought the advice of health care professionals. A typical example of a BIID patient (Mr. R), and an 11-item “BIID Questionnaire” were drafted by the authors and were used to assess the degree to which British (n=25) and German (n=58) health care professionals are informed about causes and symptoms of BIID sufferers. Results of the present study revealed that 41% of the participants correctly diagnosed BIID or Apotemnophilia. Yet, almost 30% misdiagnosed the case as Body-Dysmorphic or as Somatisation disorder. More than 85% of the participants tended not to contact the medical officer to affect the hospitalisation of the patient in a mental institution. 12% of the therapists answered with “rather/definitely yes”. Almost 70% of the therapists answered that they would try to convince the patient to go voluntarily to a psychosomatic institution. When asked whether they would support the patient to satisfy his wish for amputation, more than 91% denied, 7% of the participants answered with “rather yes”, and only one out of 83 therapists with “definitely yes”. We found only small differences between therapists from UK and Germany. Professionals in Germany more often tended to recommend psychosomatic clinics, therapists from Great Britain more European Journal of Counselling Psychology 2009, Vol. 1, No. 2 17 frequently suggested treatment with psychotropic medications. Female professionals voted more often for supporting the patient to fulfil his wish for amputation.


Body Integrity Identity Disorder; BIID; Apotemnophilia