Introduction:
A few humankind encounter the thought of excision of a specific leg, which, with time, turns out to be a robust, persistent desire or urge until the goal is met. They even have a wish to become deaf or blind. Eventually, their thoughts and behavior progress accordingly. This craving for the amputation of legs will interfere with emotions, daily tasks, and social interaction. So, it is a hazardous condition to concern oneself with.
The first instance of two people wanting to amputate their healthy limbs was documented in 1977. In the past, body integrity dysphoria was thought to have a sexual orientation as a likely cause. Subsequently, however, it was discovered that the patient's urge for limb removal was motivated by other nonsexual factors in addition to a sexual one. The first surgeon in history to perform amputations on healthy people was Robert Smith. In 1997 and 1999, Robert Smith carried out two elective amputations on apparently healthy patients. Referring to this ailment as a disease of body identity, he stated that patients yearned for amputation and felt content following their transition.
What Is Apotemnophilia?
Apotemnophilia is a formerly called term for body integrity dysphoria. It is a psychological disorder of having a persistent desire for physical or sensory disability or possessing a queer sense of being bodied. They desire for amputation of body limbs, usually a leg. Such thoughts begin in childhood, but the desire starts in early adolescence. However, the condition is psychological in origin but holds a neurological aspect. Various terms know as Apotemnophilia:
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Body integrity dysphoria.
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Body integrity identity disorder (BIID).
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Amputee identity disorder.
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Xenomelia.
What Causes Apotemnophilia?
The exact cause is undetermined as of 2015, and it needs to be clarified why an individual is holding such a desire. However, a few people with apotemnophilia concerning the left side have less gray matter in their right superior parietal lobules, as per the magnetic resonance imaging (MRI) scans. Hence, the amount of gray matter is somehow associated with body integrity dysphoria. In addition, people are more preferably to encounter intense desire, as demonstrated.
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The individuals commence having the dream of amputation at a younger age, usually between the ages of 8 and 12. This dream or wish consequently becomes the urge through the ages. Thus, at the elder stage, they seek treatment for amputation.
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Males are more likely to develop body integrity dysphoria than females. But, there is no gender prevalence.
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At times, apotemnophilia seems comorbidity with paraphilia or intense sexual arousal.
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Early childhood trauma, incline in amputees discovering and obsessive compulsion temperament could contribute to the development of apotemnophilia.
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Consequently, apotemnophilia has no correlation with family history and past trauma or injury to the limb. And it is weakly associated with personality disorders.
How Many Individuals Are Affected by BIID?
This condition is extremely uncommon. It can be challenging to determine the precise number of affected individuals, though, as some may choose to conceal their illness. Individuals suffering from BIID may distance themselves from bodily parts they are not emotionally attached to and steer clear of conversations about the condition.
What Incorporates the Signs and Symptoms of Apotemnophilia?
Apotemnophilia is a rare condition and holds an indistinct distinction between psychiatry and neurology, physical and mental health conditions. This sparingly studied condition features the prominent sign of the desire to amputate the leg or other limbs. In addition, the individual carries the succeeding symptoms, but the whole relies on the desire for amputation.
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A desire for paralysis of the leg.
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Desire over blindness or deafness.
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Distorted thoughts lead to distress yet interfere with social and daily functioning.
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Sense of sexual arousal is associated with the desire for execution, movement, and mind.
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Some present their conduct as blind, deaf, or lost limbs. So, they pretend to utilize prostheses such as wheelchairs.
What Is the Complication of Apotemnophilia?
The usual onset of apotemnophilia is about 8 to 12 years old. The significant risk factor of this condition is knowing an amputee as a child. The complication associated with this condition is rare and could involve certain degrees of cognitive decline. Self-amputation is considered a significant complication of apotemnophilia since the condition specifies amputation (spontaneous detachment or withdrawal of leg). Self-amputation is an extreme form of self-mutilation, and it is associated with psychosis. However, this complication is regarded as rare for the individual to remove the leg from the body.
How Is Apotemnophilia Diagnosed?
It is hard to diagnose the condition at times, as it has to deal with both body and brain. The recognition is so complicated that the person never easily comes up with their intense, unusual desire to discard the leg. So, instead, the medical healthcare professionals rule out the condition on examination, interviewing, and determining any underlying benign tumor or other illnesses.
Body integrity dysphoria is constituted in the category of disorders of bodily distress or experience, according to the International Classification of Disorders (ICD), eleventh edition.
What Are the Treatment Options for Apotemnophilia?
Unfortunately, there are no cure or intervention techniques for body integrity dysphoria. However, there are reports that antidepressant medication (selective serotonin reuptake inhibitors), and cognitive behavioral therapy will somehow cope with and alleviate depression and emotional distress.
Cognitive Behavioral Therapy (CBT):
Cognitive behavioral therapy is commonly employed psychotherapy or talk therapy for various cognitive impairments, primarily anxiety and depression. It incorporates the principles of both cognitive and behavioral themes. The treatment aims at identifying and resolving distorted thoughts, behavior, and conduct. Thus, the client’s emotional regulation is advanced. The therapy holds six subsequent phases of changing false and bizarre thought patterns while employing through the sessions.
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Psychological assessment.
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Reconceptualization.
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Acquisition of skills.
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Skills consolidation and their applications.
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Generalization and maintenance.
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Post-intervention follow-up.
Antidepressants:
Antidepressants are prescribed against major depression, chronic pain, and certain anxiety disorders. In addition, as apotemnophilia individuals endure depression and emotional strain as a consequence of intense desire, selective serotonin reuptake inhibitors (SSRI) drugs, a type of antidepressant, are usually recommended. The commonly advised SSRIs are as follows.
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Citalopram.
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Escitalopram.
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Fluoxetine.
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Paroxetine.
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Sertraline.
These interventions are employed not to resolve the urge for amputation but for the concern of the cognitive distortions that are left behind.
Research indicates that a high number of self-amputation instances have been linked to psychosis. For the previous 28 years, a 40-year-old French woman with burns to her lower extremities disclosed that she was considering having both of her legs severed.
If surgeons decline to amputate, patients purposefully injure their limbs. In one instance, a patient used dry ice to freeze both of the legs to execute self-amputation.
Amputations are only carried out by surgeons after all other options have been exhausted, and the patient is still in dire need of one. Following the procedure, patients in most cases reported feeling satisfied.
Prognosis of Apotemnophilia:
The prognosis of body integrity dysphoria is neither favorable nor unfavorable as it is not ascertained regarding the outcome of both treated and untreated conditions. But the fact is that the relief of intense desire can be achieved permanently through amputation, as per several reports.
What Can One Do to Prevent BIID from Impacting the Health?
Body integrity dysphoria can potentially begin in childhood and produce misery that lasts a lifetime. However, recognizing this illness and contacting a physician or psychiatrist might assist one with beginning to manage the symptoms.
Speaking with a dependable friend or relative might also aid in understanding the circumstances. This starts discussions about choosing the best course of action for treating symptoms. Amputation may be able to lessen the condition's pain in some circumstances. However, this must be carried out by a licensed surgeon in a valid and secure setting after the necessary mental examination and evaluation.
BIID is not currently included in the Diagnostic and Statistical Manual (DSM) or accepted as a mental health diagnosis. Nonetheless, some medical professionals are attempting to argue for its wider acknowledgment. More interest in the disorder, additional studies, and more effective therapy choices than currently available would result from including BIID in the handbook.
What Is the Difference Between Dysphoria and Dysmorphia?
Body dysmorphic disorder (BDD) is a mental health issue, while gender dysphoria is not. This is a significant distinction between the two conditions. A feeling of uneasiness that a person may experience if their biological sex and real gender identity are inconsistent is known as gender dysphoria. A person's feeling of gender, which may or may not correspond to their biological sex at birth, is known as their gender identity.
A mental health problem known as body dysmorphic disorder (BDD) or body dysmorphia. The easiest way to characterize it is as an anxiety illness, more especially as a kind of obsessive-compulsive disorder, in which the person believes that a certain bodily feature or way of looking is flawed or incorrect.
Conclusion:
Philia, in general, denotes fondness for a specified thing. The person has a significant love and persistent longing to attain such a thing. In the manner of expressing the desire, apotemnophilia people aspire to amputate a part of the body or have a fancy for blindness or deafness. The desire seems right in their perspective, and they usually denote them as 'transabled.' As early as it is identified, it must be considered and managed effectively on the underlying cognitive thought patterns and behavior.
