Pica Eating Disorder

Original Editor - Syeda Bushra Zehra Zaidi

Top Contributors - Syeda Bushra Zehra Zaidi

Introduction

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.

Epidemiology

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 consumptionIn recent studies,The prevalence estimate ranging from 0.3% to 15.5% in children and adolescents and from 0.8% to 4.5% adults.

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.

Symptoms

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

Behavioral Symptoms of Pica:

• 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.

Psychological Symptoms of Pica:

• 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.

Physical Symptoms of Pica:

• 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

Treatment approaches

Treatment for pica can be categorized into two distinct domains: pharmacological and psychosocial interventions. In the realm of pharmacological treatments, there is no specific medication that is deemed necessary for pica. Although no clinical trials have been conducted to evaluate the efficacy of pharmacological treatments for pica, several behavioral techniques have been employed to reduce pica behavior. In this context, Lourie [139] proposed a psychoeducational treatment approach, where patients are educated about the potential risks associated with pica, particularly the risk of lead poisoning.

Psychosocial interventions / psychosocial counselling

Successfully treating pica in a specific patient hinges on a comprehensive understanding of their unique pica behavior. Currently, therapeutic approaches are the most suitable for addressing pica. These methods encompass several elements, such as initial screening, guidelines to differentiate between edible and non-edible items, self-protective devices to prevent the ingestion of contaminants, reinforcement of visual cues, uneven reinforcement of alternative or opposing behaviors, and providing physical and sensory stimulation for infants and young children. These strategies can be instrumental in addressing these issues and managing economic and social isolation concerns. Additionally, it's imperative to obtain information regarding the adverse effects of pica, and taking steps to eliminate toxic substances, such as lead-based paints, from the environment is crucial.