Kasten Erich
Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, 20457 Hamburg, Germany.
Healthcare (Basel). 2023 Jun 30;11(13):1901. doi: 10.3390/healthcare11131901.
One of the strangest kinds of misperceptions of the body is "Body Integrity Dysphoria" (BID), formerly named as "Body Identity Integrity Disorder" (BIID). The affected people have the feeling that a limb is not part of their body. They can feel it, they can use it, they can move it, but they cannot get along with the fact that it is a part of their own body. Most feel the need for an amputation of a leg, others of both legs, some want a palsy and use a wheelchair. Still discussed is whether other disablements such as blindness, dumbness, deafness or a desire to have an incontinency can be included in this diagnosis. This review discusses parallels and differences to transgender/trans identity, body dysmorphic disorder, alien limb syndrome, hemineglect, and self-induced amputations in schizophrenic patients. The cause for the need to be disabled is still unknown; the review gives an overview about psychological and neurological theories of explanation and what kind of therapy may help.
This is a narrative review of about 20 years of research about Body Integrity Dysphoria by the author.
Overall, no psychopathological deviations were found, none of the affected persons examined by us were actually delusional or schizophrenic, which underlines that there is a neurological malfunction in the brain that has existed since birth. However, psychological mechanisms intensify the symptoms. There are clear parallels to other forms of interference between the external body and mental body representation. Different types of therapies have been able to provide help to better deal with BID, but there has been little to bring about a real cure. In contrast, BID-affected persons who achieved amputation (or other desired forms of disability) were satisfied and able to return to work.
BID remains an enigmatic disorder. We have learned a lot over the past 20 years that the mental and physical bodies do not have to match.
对身体最奇怪的误解之一是“身体完整性焦虑症”（BID），以前称为“身体身份完整性障碍”（BIID）。患者感觉某个肢体不属于自己的身体。他们能感觉到它，能使用它，能移动它，但他们无法接受它是自己身体一部分的事实。大多数人觉得需要截肢一条腿，其他人则想截掉双腿，有些人希望造成瘫痪并使用轮椅。目前仍在讨论其他残疾情况，如失明、失聪、失哑或渴望大小便失禁是否可纳入该诊断范畴。本综述探讨了它与跨性别/跨身份认同、身体变形障碍、异己肢体综合征、偏侧忽视以及精神分裂症患者自我诱导截肢之间的异同。导致渴望残疾的原因尚不清楚；本综述概述了相关的心理学和神经学解释理论以及哪种治疗方法可能有所帮助。
这是作者对关于身体完整性焦虑症约20年研究的叙述性综述。
总体而言，未发现精神病理学偏差，我们检查的所有患者实际上都没有妄想或精神分裂症，这表明大脑存在自出生就有的神经功能障碍。然而，心理机制会加剧症状。它与外部身体和心理身体表征之间的其他干扰形式有明显的相似之处。不同类型的治疗方法能够帮助更好地应对身体完整性焦虑症，但几乎没有能真正治愈的。相比之下，接受截肢（或其他期望的残疾形式）的身体完整性焦虑症患者感到满意并能够重返工作岗位。
身体完整性焦虑症仍然是一种神秘的疾病。在过去20年里我们了解到很多，即精神身体和物理身体不一定相符。
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