Pica Eating Disorder: Difference between revisions

Pica condition is a pattern of consumption of non-nutrient substances. There are several reasons behind that such as shortages of iron and zinc. Though pica may have a negative impact on physical functioning, it rarely impairs social functioning, often associated with comorbid disorders. The things consumed may be harmless, or can even cause death at times. Pica is more popular in children. Pica is often underreported. Pica also constitutes a deadly type of self-injurious behaviour. This behavior is more prevalent in those with behavioral and intellectual handicaps.[1]

Pica epidemiology is associated with food. Geophagia is the most prevalent form of pica in poor people and people living in Tropical regions and Tribal group-oriented societies. Pica is widespread in western Kenya, southern Africa and India. It has been recorded in Australia, Canada, Jamaica, Wales etc.

Global Perspective:In certain nations such as Uganda, India, and Iran, etc., soil may be purchased for consumption[1]In recent studies,The prevalence estimate ranging from 0.3% to 15.5% in children and adolescents and from 0.8% to 4.5% adults.[2]

Impact of COVID-19 Pandemic: During the COVID-19 pandemic, the incidence of eating disorders has still increased espacially in young adult it may be due to isolation restriction and limitation on daily activities and media exposure may contribute to increase risk.[2]

There are many sign and symptoms of PICA some which are listed below in following categories,

Behavioral Symptoms of Pica:[edit | edit source]

  • Cravings and Consumption: Behavioral symptoms of Pica include the persistent cravings for and consumption of non-food substances. Individuals with Pica often express a strong desire or compulsion to eat these items.
  • Repetitive Ingestion: Pica involves the repetitive and compulsive consumption of non-food items, indicating a behavioral pattern of this unusual eating behavior.
  • Knowledge of Inedibility: Individuals with Pica generally understand that the substances they are consuming are not edible and do not provide proper nutrition. However, their behavior is driven by an intense compulsion to consume these items despite their knowledge.
  • Age and Developmental Stage: In children, Pica may initially manifest as exploratory behavior, which is developmentally normal. In these cases, the behavior is usually not driven by cravings or compulsion but rather curiosity. The transition to clinical Pica occurs when these behaviors persist beyond early childhood or when they occur in adults.[3]

Psychological Symptoms of Pica:[edit | edit source]

  • Anxiety and Stress: Pica is often linked to psychological symptoms, such as anxiety and stress. Individuals may use the behavior as a coping mechanism to alleviate emotional distress.
  • Emotional Distress: Individuals with Pica may experience emotional distress, shame, embarrassment, or frustration due to their unusual eating behavior, especially when it leads to social stigma or health complications.
  • Underlying Mental Health Conditions: In some cases, Pica may co-occur with or be a symptom of other mental health conditions, such as obsessive-compulsive disorder (OCD), autism spectrum disorder, or schizophrenia.[4]

Physical Symptoms of Pica:[edit | edit source]

  • Gastrointestinal Complications: Prolonged consumption of non-food items can lead to physical health issues, such as gastrointestinal problems, including blockages, ulcers, constipation, or even perforations in the digestive tract.
  • Nutritional Deficiencies: As individuals with Pica may consume non-nutritive substances instead of proper nutrition, they can develop nutritional deficiencies, leading to physical symptoms like weakness, fatigue, anemia, or failure to thrive (in children).
  • Dental Damage: Pica can result in physical damage to the teeth, including tooth erosion, chipping, or cracking, due to abrasive or hard substances ingested.
  • Toxicity or Poisoning: Some non-food items can be toxic or harmful, potentially causing physical symptoms like poisoning, illness, or allergic reactions.
  • Infection or Parasitic Contamination: Consuming items like dirt or feces may lead to physical symptoms related to infection, such as gastrointestinal distress, diarrhea, or parasitic infestations[5]

Therapy can be carried out in two separate fields namely pharmacological and psychosocial treatments. Pharmacological interventions / pharmacological treatment No specific medical cure is required for pica. No pharmacological treatment trials have been performed for pica while several behavioral techniques have been used to diminish pica behavior, Lourie [139] recommended a psychoeducation treatment approach. Patient would be instructed about the danger of pica that could result in lead poisoning.[6]

Psychosocial interventions / psychosocial counselling[edit | edit source]

A thorough consideration of the particular patient’s pica behavior process is key to successful treatment. Currently, therapeutic strategies are considered the most appropriate for the treatment of pica. Those include the following such as preliminary screening, Guidelines for discrimination between items edible and non-edible, Self-protection devices that prevent contaminants from being put in the mouth, Reinforcement of the visual, Unequal reinforcement of other or contradictory behaviors. Physical and sensory stimulation between infants and young children may be given in pica. It can be helpful to tackle these problems and to handle economic concerns and social isolation. Information about the adverse effects of pica needs to be received. It is necessary to remove toxic substances like lead based paints from the environment[1]

  1. Rajput N, Kumar K, Moudgil K. Pica an eating disorder: an overview. Pharmacophore. 2020 Jul 1;11(4).
  2. 2.02.1 Silén Y, Keski-Rahkonen A. Worldwide prevalence of DSM-5 eating disorders among young people. Curr Opin Psychiatry. 2022;35(6):362-371. doi:10.1097/YCO.0000000000000818
  3. Parry-Jones B, Parry-Jones WL. Pica: symptom or eating disorder? A historical assessment. The British Journal of Psychiatry. 1992 Mar;160(3):341-54.
  4. Hartmann AS, Zenger M, Glaesmer H, Strauß B, Brähler E, de Zwaan M, Hilbert A. Prevalence of pica and rumination behaviours in adults and associations with eating disorder and general psychopathology: findings form a population-based study. Epidemiology and Psychiatric Sciences. 2022;31:e40.
  5. Saboowala HK, editor. What Is Pica (Eating Disorder)?-Definition, History, Causes, Symptoms, Diagnosis and Treatment. Dr. Hakim Saboowala;.
  6. Blinder BJ, Goodman SL, Henderson P. Pica: a critical review of diagnosis and treatment. The Eating Disorders. 1988;331:344.

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