Call our National Helpline on 01-2107906 or email


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.


  • 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
Advani, S. et al. (2014) Eating everything except food (PICA): A rare case report and review. Journal of International Society of Preventive & Community Dentistry, 4(1), 1-4.

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.

Baheretibeb, Y. et al. (2008) The girl who ate her house—pica as an obsessive-compulsive disorder: A case report. Clinical Case Studies, 7(1), 3-11.

Barton, J.C. et al. (2010) Pica associated with iron deficiency or depletion: Clinical and laboratory correlates in 262 non-pregnant adult outpatients. BMC Blood Disorders, 10:9.

Bhatia, M.S. et al. (2005) Behavioural problems in children with down syndrome. Indian Pediatrics, 42(7), 675-680.

Bhatia, M.S. & Gupta, R. (2009) Pica responding to SSRI: an OCD spectrum disorder? World Journal of Biological Psychiatry, 10(4 Pt 3), 936-8.

Bhatia, M.S. & Kaur, J. (2014) Pica as a culture bound syndrome. Delhi Psychiatry Journal, 17(1), 144-147.

Bhatia, M.S. & Kaur, N. (2014) Pagophagia – A common but rarely reported form of pica. Journal of Clinical and Diagnostic Research, 8(1), 195-196.

Borgna-Pignatti, C. & Zanella, S. (2016) Pica as a manifestation of iron deficiency. Expert Review of Hematology, 9(11), 1075-1080.

Call, N.A. (2015) Clinical outcomes of behavioural treatments for pica in children with developmental disabilities. Journal of Autism and Developmental Disorders, 45(7), 2105-2114.

Delaney, C.B. et al. (2015) Pica and rumination behaviour among individuals seeking treatment for eating disorders or obesity. International Journal of Eating Disorders, 48(2), 238-48.

Fawcett, E.J. et al. (2016) A meta-analysis of the worldwide prevalence of pica during pregnancy and the postpartum period. International Journal of Gynecology & Obstetrics, 133(3), 277-283.

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.

Kettaneh, A. (2005) Pica and food craving in patients with iron-deficiency anemia: A case-control study in France. American Journal of Medicine, 118(2), 185-8.

Khan, Y. & Tisman, G. (2010) Pica in iron deficiency: a case series. Journal of Medical Case Reports, 4, 86.

Johnson, C.D. et al. (2007) An unusual case of tooth loss, abrasion, and erosion associated with a culturally accepted habit. General Dentistry, 55(5), 445-8.

Lumish, R.A. et al. (2014) Gestational iron deficiency is associated with pica behaviours in adolescents. Journal of Nutrition, 144 (10), 1533-1539

Matson, J.L. et al (2013) Pica in persons with developmental disabilities: Approaches to treatment. Research in Developmental Disabilities, 34(9), 2564-2571.

Moore, Jr. D.F & Sears, D.A. (1994) Pica, iron deficiency, and the medical history. The American Journal of Medicine, 97(4), 390-393.

Murray, H.B. et al. (2018) Prevalence in primary school youth of pica and rumination behaviour: The understudied feeding disorders. International Journal of Eating Disorders, 51(8), 994-998.

McNaughten, B., Bourke, T., Thompson, A. (2017) Fifteen-minute consultation: The child with pica. Archives of Disease in Childhood – Education and Practice, 102(5), 226-229.

Santos, A.M. et al. (2016) Pica and eating attitudes: A study of high-risk pregnancies. Maternal and Child Health Journal, 20(3), 577–58.

Singh, A.P. (2013) Pica – A case report on eating disorder of rural adolescent girl. International Journal of Scientific and Research Publications, 3(9), ISSN 2250-3153.

Stein, D.J. et al. (1996) Pica and the obsessive-compulsive spectrum disorders. South African Medical Journal, 86, (12 Suppl):1586-8, 1591-2.

Williams, D.E & McAdam, D. (2016) Pica. Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities. pp 715-726

Zhao, Y. & Encinosa, W. (2011) An update on hospitalizations for eating disorders, 1999 to 2009. Statistical brief #120. Agency for Healthcare Research and Quality.