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What is Pica?

Updated: Oct 8, 2020

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Pica is characterized by eating items of no nutritional value such as ice, soap, dirt, or paint. This eating disorder is usually observed in children, pregnant women, or individuals with mental disabilities. Pica is generally temporary.



Diagnosis Criteria

Credit to NEDA.

  • There are no laboratory tests for Pica. Instead, the diagnosis is made from a clinical history of the patient.

  • Diagnosing Pica should be accompanied by tests for anemia, potential intestinal blockages, and toxic side effects of substances consumed (i.e., lead in paint, bacteria, or parasites from dirt).


Symptoms

Credit to NEDA.

  • The persistent eating, for at least one month, of substances that are not food and do not provide nutritional value.

  • The ingestion of the substance(s) is not a part of culturally supported or socially normative practice (e.g., some cultures promote eating clay as part of a medicinal practice).

  • Typical substances ingested tend to vary with age and availability. They may include paper, soap, cloth, hair, string, wool, soil, chalk, talcum powder, paint, gum, metal, pebbles, charcoal, ash, clay, starch, or ice.

  • The eating of these substances must be developmentally inappropriate. In children under two years of age, mouthing objects—or putting small objects in their mouth—is a normal part of development, allowing the child to explore their senses. Mouthing may sometimes result in ingestion. To exclude developmentally standard mouthing, children under two years of age should not be diagnosed with Pica.

  • Generally, those with Pica are not averse to ingesting food.


Causes

The most common causes are iron-deficiency anemia, malnutrition, pregnancy, and mental health disorders associated with impaired functioning. The body is attempting to correct significant nutrient deficiencies; treating the deficiencies often resolves the problems.



Statistics

Credit to NEDA.

Between 4%-26% of institutionalized individuals are believed to have Pica.

Walke. C. E., Michael C. R.( 2001), Handbook of Clinical Child Psychology, John Wiley and sons, 3ed edition 692-713.

Health Consequences

Gastrointestinal

  • Obstruction, infection, or rupturing of the intestine:

  • Ingested items can cause mechanical problems

  • Prevent food or water passage through intestines

  • Bezoar

  • Holes in the wall of the stomach, intestines, or bowels

  • Infections or poisoning can occur from toxic materials

Treatment Options

The first step in treatment is testing for malnutrition, then correcting that. Typically, correcting the nutrient deficiencies solves the problems, but if not, there are behavioral therapies available.


Book: Clinical Handbook of Complex and Atypical Eating Disorders

Author: Anderson, L.K.; Murray, S.B.; Kaye, W.H.

Publish Date: September 26, 2017

Price: $69 (Paperback)

Description: "Clinical Handbook of Complex and Atypical Eating Disorders brings together into one comprehensive resource what is known about an array of complicating factors for patients with ED, serving as an accessible introduction to each of the comorbidities and symptom presentations highlighted in the volume. The first section of the book focuses on the treatment of ED in the presence of various comorbidities, and the second section explores the treatment of ED with atypical symptom presentations. The third section focuses on how to adapt ED treatments for diverse populations typically neglected in controlled treatment trials: LGBT, pediatric, male, ethnically diverse, and older adult populations. Each chapter includes a review of clinical presentation, prevalence, treatment approaches, resources, conclusions, and future directions. Cutting edge and practical, Clinical Handbook of Complex and Atypical Eating Disorders will appeal to researchers and health professionals involved in treating ED."


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