Pica

What is it?

According to the American Psychiatric Association (APA), Pica involves the compulsive eating of non-nutritive, non-food substances inappropriate to the developmental level of the individual. The eating behaviour is not part of a culturally or socially supported practice. Cultural beliefs and practices may play a role some societies, though cultural Pica is distinct from childhood Pica.

  • Research on Pica, including possible causes, is limited
  • The prevalence may be under-reported due to feelings of embarrassment
  • Iron deficiencies may be an underlying factor in some cases
  • Can occur during and after pregnancy
  • Can affect some people with autism spectrum disorder (ASD) and/or intellectual disability (ID)

Examples of non-food substances

A person may consume soil, clay, paint, paper, coal, wood, string, pebbles, hair, ice or freezer frost.

Consequences

  • Medical complications such as lead poisoning, bowel and intestinal problems and mineral deficiencies
  • Constipation, ulcerations, perforations
  • Dental problems – abrasion and damage to tooth substance, tooth surface loss
  • Pica can be life-threatening, resulting in surgery

Treatment options

  • Medication, psychological evaluation and/or behavioural interventions
  • Applied behaviour analysis (ABA)
  • A multi-disciplinary approach
References:

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Ashworth, M. et al (2009) The social and recreational characteristics of adults with intellectual disability and pica living in institutions. Research in Developmental Disabilities, 30(3), 512-520.

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Hartmann, A.S. et al. (2012) Pica and rumination disorder in DSM-5. Psychiatric Annals, 42(11), 426-430.

Hartmann, A.S. et al. (2018) Prevalence of pica and rumination behaviours in German children aged 7–14 and their associations with feeding, eating, and general psychopathology: A population-based study. European Child & Adolescent Psychiatry, 27(11), 1499–1508.

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