More work is needed to explain why patients ask for amputation of healthy limbs

doi:10.1136/bmj.320.7242.1147/a

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Keren Fisher, consultant clinical psychologist,
Robert Smith, consultant general surgeon

Psychology Department, Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex HA7 4LP

EDITOR—Dyer reports that a surgeon in Scotland amputated the legs of two psychologically disturbed men who had nothing physically wrong with the limbs.1 There are several discrete groups of patients requiring such amputation, the most relevant being the group with a mismatch between their actual and perceived body schema. We have studied the psychological processes of seven such patients and have had correspondence with three others. We have used standardised mental health instruments and …