See Inside December 2007/January 2008

Amputee Envy

People with body integrity identity disorder feel alienated from a part of their body and want to have it amputated. Researchers are unraveling clues to the causes of this bizarre condition

In 1997 Robert Smith, a surgeon at the Falkirk and District Royal Infirmary in Scotland, fulfilled one of his patient's deepest desires: he amputated the lower part of the man's left leg. Smith performed a similar operation on a German retiree two years later, the British daily The Independent reported in 2000. Neither procedure was medically necessary. Both patients had told Smith that one of their legs was superfluous and that its mere presence had caused them enduring emotional pain.

Psychiatrists estimate that several thousand people worldwide, most of them male, wish to get rid of a normal healthy limb; a smaller number actually request its surgical removal. Such radical requests stem from an extremely rare psychiatric illness called body integrity identity disorder (BIID).

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