apotemnophilia

[kelber at mindspring.com]

Ick.

---Original Message-----
From: KXX4493553 at aol.com
Sent: Nov 19, 2005 3:18 AM
To: Pynchon-L <pynchon-l at waste.org>
Subject: apotemnophilia

Institute of Extramural Medicine (EMGO), Amsterdam, The  Netherlands.

Background: The syndrome of apotemnophilia, body integrity  or amputee
identity disorder, is defined as the desire for amputation of a  healthy
limb, and may be accompanied by behaviour of pretending to be an  amputee and
sometimes, but not necessarily, by sexual arousal. Sampling and  Methods: A
case history is presented of a 35-year-old man who was referred  because of
his desire for amputation of his left leg, without sexual  connotations. The
course of a combined cognitive behavioural psychotherapy  with SSRI treatment
is described. Results: Symptoms showed considerable  similarity with
obsessive-compulsive disorder, and some similarity with body  dysmorphic
disorder according to DSM-IV, but the core symptom seemed to be  strongly
connected with a sense of identity. Treatment with a selective  serotonin
re-uptake inhibitor decreased levels of distress only. The effects  of
cognitive restructuring of the psychotherapy were limited, whereas  the
behavioural elements substantially reduced the behaviour of pretending to  be
an amputee. Conclusions: The rare syndrome of apotemnophilia  raises
unresolved questions of classification. Psychotic disorders should be  ruled
out carefully. The model designed in the current cognitive  behavioural
approach may serve as a starting point for further development  of
intervention protocols for this rare disorder. Copyright (c) 2006 S.  Karger
AG, Basel.

PMID: 16282717 [PubMed - as supplied by  publisher]

kwp