Psychiatric Clinic Slovak Medical University and University Hospital Bratislava, Bratislava, Slovakia.
Psychiatry Outpatient Clinics, University Hospital of The Brothers of Saint John of God in Bratislava, Bratislava, Slovakia.
Psychopathology. 2022;55(5):310-316. doi: 10.1159/000522596. Epub 2022 Mar 29.
We present a rare, atypical case of a 24-year-old transgender male (assigned as a female at birth) admitted to the hospital after the planned self-amputation of his left hand. The patient described his motivation for this self-amputation as coming from deep-rooted and persistent feelings that this hand was not a part of his body. He identified himself as having, according to internet peer group definition, body integrity identity disorder. This condition is now referred to as body integrity dysphoria (BID). This patient was later diagnosed as having gender dysphoria and other conditions, including bipolar disorder and gaming disorder. The follow-up 2 years after self-amputation is presented, during which, despite antipsychotic and antidepressant treatment, the symptoms of BID remained unchanged and the high variability of other psychopathology was observed. This is an unusual case of BID simply because several other comorbidities are presented. Like many other rare clinical situations, this case also presents a particular challenge to our understanding of the dynamics and interrelationships between comorbidities, raising concerns and questions.
我们呈现了一个罕见的、非典型的 24 岁跨性别男性（出生时被指定为女性）的案例，他在计划自行切断左手后被送进了医院。该患者将自己进行这次自我截肢的动机描述为源于根深蒂固且持续的感觉，即这只手不属于他的身体。他认为自己符合互联网同侪群体对身体完整性认同障碍的定义。这种情况现在被称为身体完整性障碍（BID）。该患者后来被诊断出患有性别焦虑症和其他疾病，包括双相情感障碍和游戏障碍。我们呈现了自截肢后 2 年的随访情况，在此期间，尽管进行了抗精神病药和抗抑郁药治疗，BID 的症状仍未改变，并且观察到其他精神病理学的高度可变性。这是一个不寻常的 BID 案例，仅仅是因为还存在其他几种合并症。像许多其他罕见的临床情况一样，这种情况也对我们理解合并症之间的动态和相互关系提出了挑战，引发了关注和疑问。
