Apotemnophilia or body integrity identity disorder (BIID) is defined by the uncontrollable desire to amputate one or more healthy limbs or to be paraplegic.

We reviewed the available studies of this condition in order to enhance the comprehension of this disorder and the possible need of a multidisciplinary assessment.

Relevant papers from 2000 were identified using PubMed database, with the terms apotemnophilia, BIID and self-demand amputation.

Reports of the phenomenon of amputee attraction trace back to 1933 in a series of letters and articles published in journals and magazines by erotically-obsessed persons who wanted to become amputees themselves. The first scientific report of this issue only appeared in 1977, when John Money described two cases that requested an amputation of a healthy limb, a condition he named apotemnophilia. Would-be amputees – or “wannabes” – may appear in thousands and they have their own websites. Until now, the explanation of this phenomenon has been in favor of a psychiatric etiology: a pathological desire driven by a sexual compulsion. Recently, a neurological explanation has been proposed and defends that might exist a dysfunction of the right parietal lobe, leading to a distorted body image and a desire for an amputation.

Apotemnophilia is a rare, uncommonly studied condition, which blurs the limits between psychiatry and neurology. We must be aware that this disorder is more frequent in unusual places like websites and others. A better understanding of this condition is crucial for the development of effective treatment.

The authors have not supplied their declaration of competing interest.