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Definition
Pica is an eating disorder typically defined as the persistent ingestion of nonnutritive substances for a period of at least 1 month at an age at which this behavior is developmentally inappropriate (after 18-24 months).
A diagnosis of pica occurs when the behavior is inappropriate to the developmental level of the individual, is not part of a culturally sanctioned practice, and does not occur exclusively during the course of another mental disorder.
Pica can occur during pregnancy. In some cases, a lack of certain nutrients, such as iron deficiency anemia and zinc deficiency, may trigger the unusual cravings.
Symptoms
Individuals who have pica have been reported to mouth and/or ingest a wide variety of nonfood substances, including, but not limited to, clay, dirt, sand, stones, pebbles, hair, feces, lead, laundry starch, vinyl gloves, plastic, pencil erasers, ice, fingernails, paper, paint chips, coal, chalk, wood, plaster, light bulbs, needles, string, cigarette butts, wire, and burnt matches.
-Infants and children commonly ingest paint, plaster, string, hair, and cloth.
-Older children tend to ingest animal droppings, sand, insects, leaves, pebbles, and cigarette butts.
-Adolescents and adults most often ingest clay or soil.
Prevalence
The prevalence of pica is unknown, as the disorder often is unrecognized and underreported. Pica is reported most commonly in children and in individuals with mental disabilities. Children with mental disabilities and autism are affected more frequently than children without these conditions. Among individuals with mental disabilities, pica is the most common eating disorder.
Pica is observed more commonly during the second and third years of life and is considered developmentally inappropriate in children older than 18-24 months. Research suggests that pica occurs in 25%-33% of young children and 20% of children seen in mental health clinics.
Treatment
No medical treatment is specific in the treatment of patients with pica.
Psychologist/psychiatrist
Careful analysis of the function of pica behavior in individuals is critical to effective treatment.
Currently, behavioral strategies have been most effective in treating pica.
Social Worker
Assessment of cultural beliefs and traditions may reveal the need for education regarding the negative effects of pica.
Diet
Assessment of nutritional beliefs may be relevant in the treatment of some patients with pica.
The Handbook for Clinical Child Psychology currently supports general behavioral strategies as the most effective treatment approach for pica, with training in which foods are edible and which foods cannot be eaten through the use of positive reinforcement.
Outlook
Treatment success varies. In many cases, the disorder lasts several months, then disappears on its own. In some cases, it may continue into the teen years or adulthood, especially when it occurs with developmental disorders.
References:
http://www.nlm.nih.gov/medlineplus/ency/article/001538.htm
http://emedicine.medscape.com/article/914765-overview
http://www.webmd.com/mental-health/mental-health-pica