Apotemnophilia: a comprehensive overview.
Akano OT1,2*, Oduguwa OI2,3
1College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
2Slum and Rural Health Initiative Research Academy, Ibadan, Nigeria.
3College of Medicine, University of Ibadan, Ibadan, Nigeria.
*Correspondence: Oluwadara Tomisin Akano; +234 813 646 36233; firstname.lastname@example.org
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This paper describes apotemnophilia, a rare condition in which an otherwise healthy person has a strong desire to amputate a healthy body part. This article aims to increase awareness about the condition and extend the knowledge base of health professionals and the general population. The study involved an extensive search of the literature on the epidemiology, aetiology, symptoms, diagnosis and management of this condition. It was found that the desire to get rid of a limb can get overwhelmingly strong that the patients try to amputate themselves at a specific level. This is usually a result of the feeling of mismatch between the actual physical appearance and perceived true self of the individual. These thoughts cause distress which can disrupt the social life of those affected and distract them from their daily activities. The paper also describes the possible causes of apotemnophilia which can be psychological or neurological. Furthermore, it highlighted a set of diagnostic criteria that characterise this condition. Although there is no proven effective treatment; psychotherapy and pharmacotherapy are the mainstays of treatment.
The article reveals the need for further studies to investigate the perception of the general population about apotemnophilia and offers recommendations for improving the management of the condition.
Keywords: Apotemnophilia, Amputation, Amputee, Mental Health.
Cite this article: Akano OT, Oduguwa OI. Apotemnophilia: a comprehensive overview. Yen Med J. 2021;3(1):12–16.
- Khalil RB, Richa S. Apotemnophilia or body integrity identity disorder: a case report review. Int J Low Extrem Wounds. 2012;11(4):313-319.
- Money J, Jobaris R, Furth G. Apotemnophilia: two cases of self ‐ demand amputation as a paraphilia. J. Sex Res. 2010;13(2):112-125.
- Blom RM, Hennekam RC, Denys D. Body integrity identity disorder. PLoS one. 2012;7(4):e34702.
- First MB. Desire for amputation of a limb: paraphilia, psychosis, or a new type of identity disorder. Psychol Med. 2005;35(6):919-928.
- Noll S, Kasten E. Body integrity identity disorder (BIID ): how satisfied are successful wannabes. Intl J Psychol Behav Sci. 2014;3(6):222-232.
- Bensler JM, Paauw DS. Apotemnophilia masquerading as medical morbidity. South Med J. 2003;96(7):674-676.
- Bayne T, Levy N. Amputees by choice : body integrity identity disorder and the ethics of amputation. J Appl Philos. 2005;22(1):75-86
- Berger BD, Lehrmann JA, Larson G, Alverno L, Tsao CI. Nonpsychotic, nonparaphilic self-amputation and the internet. Compr Psychiatry. 2005;46:380-383.
- Braam AW, Cath C, Hoogendijk WJG. Investigation of the syndrome of apotemnophilia and course of a cognitive-behavioural therapy. Psychopathology. 2006;39(1):32-37.
- Brang D, Mcgeoch PD, Ramachandran VS. Apotemnophilia : a neurological disorder. Neuroreport. 2008;19(13):5-6.
- Giummarra MJ, Bradshaw JL. Body integrity identity disorder : Deranged body processing, right fronto-parietal dysfunction, and phenomenological experience of body incongruity. Neuropsychol Rev. 2011;21(4):320-333.
- Brugger P. Xenomelia : a social neuroscience view of altered bodily self-consciousness. Front Psychol. 2013;4:204-209.
- Lenggenhager B, Hilti L, Palla A, Macauda G, Brugger P. Vestibular stimulation does not diminish the desire for amputation. Cortex. 2014;54:210-212.
- Blom RM, Wingen GA Van, Wal SJ Van Der, et al. The desire for amputation or paralyzation: evidence for structural brain anomalies in body integrity identity disorder (biid). PLoS One. 2016;11(11):e0165789.
- Ramachandran VS, Mcgeoch P. Can vestibular caloric stimulation be used to treat apotemnophilia? Med Hypotheses. 2007;69(2):250-252.
- First MB, Fisher CE. Body integrity identity disorder: the persistent desire to acquire a physical disability. Psychopathology. 2012;45(1):3-14.
- Barrow E, Oyebode F. Body integrity identity disorder: clinical features and ethical dimensions. BJPsych Adv. 2019;25(3):187-195.
- Sj N, Mbbs T, Bbiomed NB, Mbbs HP. Ethical dilemmas related to surgical management of body integrity identity disorder. Aust J Plast Surg. 2019;2(2):74-76.
- Bottini G, Gandola M, Sedda A, Ferrè ER. Caloric vestibular stimulation : interaction between somatosensory system and vestibular apparatus. Front Integr Neurosci. 2013;7:66-70.
- Wise TN, Kalyanam RC. Amputee fetishism and genital mutilation: case report and literature review. J Sex Marital Ther. 2000;26(4):339-344.
- Adesina M, Kanmodi K. Disability in north africa: prevalence, pattern, and recommendations. Int J Disabil Hum Dev . 2019;18(3):In Press.
- Beckford-Ball J. The amputation of healthy limbs is not an option. Br J Nurs. 2000;9(4):2016.
- Beauchamp T, Childress J. Principles of Biomedical Ethics. 7th ed. New York, NY: Oxford University Press; 2013.
- Johnston J, Elliott C. Healthy limb amputation: ethical and legal aspects. Clin Med (Lond). 2002;2(5):431-435.
- Blom RM, Guglielmi V, Denys D. Elective amputation of a “ healthy limb .” CNS Spectr. 2016;21(5):360-361.
- Olufadewa II, Adesina MA, Ayorinde T. From africa to the world: reimagining africa’s research capacity and culture in the global knowledge economy. J Glob Health. 2020;10(1):010321.
- Adesina M, Oladele R, Olufadewa II. Mental health and psychosocial support in conflicting Nigeria. Yen Med J. 2020;2(4):15-23.