Pica Disorder Introduction - OmniMedicalSearch.com

Pica, also known as pica disorder or pica syndrome, is a rare and strange eating disorder defined as the craving and persistent eating of non-nutritive substances. The word pica is the Latin terminology for magpie - a bird known for eating almost everything.

A pica diagnosis is taken into consideration when "... eating of one or more nonnutritive substances on a persistent basis" is present for at least one month. (1) Although the disorder tends to be more frequent in children, it represents one of the most common eating disorders in individuals with developmental disabilities. It was noticed that ingestion of nonfood items tends to vary with age. Infants and younger children usually eat paint chips, plastic, hair, string, or cloth. Older children eat sand, insects, pebbles, leaves, and adolescence or adults consume clay or soil. Some of the other items eaten by individuals with this condition include: coal, chalk, wood, plaster, light bulbs, needles, burnt matches, coins, coffee grounds, feces, paper, sand, stone, cigarettes buds, lead, laundry starch, vinyl gloves, rust, pencil erasers, ice, and fingernails.

Children between 18 and 24 months old tend to place in their mouth and eat non-nutritive substances. In most cases, this behavior is not considered pathological and is rather common for this age group. Pica disorder becomes a concern when this behavior persists for at least one month. It is inappropriate to the child's development if it persists after the age of 3 and it is not a manifestation of another mental disorder such as schizophrenia or Kleine-Levin syndrome.

Pica disorder is usually associated with mental retardation and pervasive developmental disorder, but it receives independent clinical attention when it becomes severe. In general, eating nonnutritive substances receive medical attention when it leads to medical complications such as (1) life-threatening poisoning with different substances usually lead poisoning (from lead found in paint or paint-soaked plaster) or hyperkalemia (as a result of burnt matchhead ingestion), (2) parasite infections (geophagia - the ingestion of clay and soil- is associated with soil-borne parasitic infections such toxoplasmosis and toxocariasis), (3) gastrointestinal tract complications (such as mechanical bowel problems, intestinal obstruction, intestinal perforation, constipation, ulcerations), and (4) dental injuries (the human teeth are not designed to chew non-food items and mouthing hard surfaces items leads to damaging, breaking, or fracturing the teeth).

In most cases the disorder is often unrecognized and underreported which negatively influences the available data. Based on the information that is available, children with mental retardation and autism are more frequently affected by pica than children without these conditions. According to DSM (Diagnostic and Statistical Manual of Mental Disorder), "among individuals with mental retardation, the prevalence of the disorder appears to increase with the severity of the retardation (e.g., it has been reported to be as high as 15% in adults with severe mental retardation)."

Some of the most common types of pica are: (1) geophagia - the consumption of soil or clay, a common practice among people living in Central Africa and Southern United States, (2) amylophagia - the consumption of starch and paste, and (3) pagophagia - the consumption of ice.

Regarding gender criteria, the disorder equally affects boys and girls, but is rare among adolescent and adult males with an average intelligence that live in developed countries. Although there is no specific racial predilection, the practice of eating nonnutritive substances seems to be more common among certain cultures and geographic populations. Although most of the available data concerns the U.S. population, pica is a disorder that occurs throughout the world. One of the most common forms of pica in the people who live in poverty, tribal-orientated societies, or in the tropics is geophagia (ingestion of clay or soil). Pica seems to be a widespread practice in western Kenya, southern Africa, and India. Some of the other countries where the disorder has been reported includes Canada, Australia, Israel, Iran, Uganda, Wales, Jamaica, and Turkey. (2)

The onset of the disorder is usually around infancy years and in most cases, it appears to last for several months and then goes into remission. In some cases however, it may occasionally continue throughout adolescence and less frequently during adulthood. Researchers suggest that the disorder occurs in 25 to 33 percent of young children and 20 percent of the children seen in mental health clinics. (2) The disorder is more commonly observed during the second and third year of life and is considered pathological if it extends over the age of 24 months. In children with mental retardation, the onset of the disease is between the age of 10 and 20 but the disorder may diminish during adulthood.

Conditions & Diseases: Eating & Weight Disorders

Pica Disorder

Pica Introduction