Several recent studies suggest significant psychiatric comorbidity as a determinant of pica. Pica is often seen in mentally or developmentally disabled persons. (1,2) Certain psychosocial stressors have been reported to be significantly associated with pica, including maternal deprivation, joint family, parental neglect, pregnancy, impoverished parent-child interaction, and disorganized family structure. Poor parental supervision and oral overstimulation, maternal pica, and cultural acceptance of pica-especially common in families with African lineage and in southern US communities-may represent the extra pressures that allow pica to become manifest in a child prone to intense oral focus of drive satisfaction. In certain ethnic populations, pica is culturally acceptable and is not considered pathological. Pica is most frequently seen in children and pregnant women. In addition, we discuss some of the associated complications as well as current treatment strategies.Īccording to DSM-IV, pica is the action of nonnutritive ingestion that is repeated for a period of at least a month and is developmentally inappropriate. In this overview of pica, we review its causes and prevalence. In the spectrum of eating disorders, pica may be viewed as a derailment of food selection and a driven, often chaotic, form of ingestive behavior. In addition, acute and chronic medical complications may pose surgical emergencies (intestinal obstruction from bezoars) as well as more subtle encroaching symptoms such as parasitosis, intoxication, and nutritional deficits. The clinical consequences of pica may have broad epidemiological implications as in lead intoxication and geophagia in children, which lead to severe impairment of intellectual and physical development. It is a complex behavior that can present with any number of variations (Table 1), and multiple pica determinants range from demands of tradition and acquired tastes in the cultural context to presumptive neurobiological mechanisms (eg, iron deficiency, CNS neurotransmission, physiological conditioning). Refeeding syndrome: A potentially fatal complication for any client with negligible food intake for more than five days that involves hypophosphatemia serious sodium and fluid imbalances changes in glucose, protein, and fat metabolism thiamine deficiency hypokalemia and hypomagnesaemia.Pica is the pathological craving for and eating of a nonnutritive item (eg, clay, coal, paper) or food ingredients (flour, raw potatoes). Purging: Behavior in eating disorders used to compensate for overeating, such as forced vomiting, excessive use of laxatives, or diuretics. Pica: An eating disorder in which an individual repeatedly eats things that are not considered food with no nutritional value, such as paper, dirt, soap, hair, glue, or chalk. Lanugo: Growth of fine hair all over the body. Unlike bulimia nervosa, periods of binge eating are not followed by purging, excessive exercise, or fasting.īinge eating episode: An episode characterized by both eating in a discrete period of time (e.g., within any two-hour period) an amount of food that is definitely larger than what most individuals would eat and a sense of a lack of control over eating during the episode.īody mass index (BMI): A person’s weight in kilograms divided by the square of height in meters.īulimia nervosa: A condition where people have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes.Įmaciation: A condition of extreme thinness.įamily-based therapy: A type of psychotherapy where parents of adolescents with anorexia nervosa assume responsibility for feeding their child. Anorexia nervosa: A condition where people avoid food, severely restrict food, or eat very small quantities of only certain foods.Īvoidant restrictive food intake disorder (ARFID): A condition where individuals limit the amount or type of food eaten.īinge eating disorder: A condition where people lose control over their eating and have recurring episodes of eating unusually large amounts of food.
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