Pica psychological disorder
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Understanding Pica: A Psychological Disorder
Definition and Classification of Pica
Pica is a psychological eating disorder characterized by the persistent consumption of non-nutritive substances for at least one month in a manner that is developmentally inappropriate and culturally unacceptable2. It is classified under the Feeding and Eating Disorders of Infancy and Early Childhood in the Diagnostic and Statistical Manual of Mental Disorders (DSM)2.
Etiology and Associated Conditions
The exact cause of pica is not clearly established, but it is associated with various conditions such as pregnancy, iron deficiency, and psychosocial problems2. Pica is also frequently observed in individuals with psychiatric disorders including psychosis, autism, intellectual disability, and obsessive-compulsive spectrum disorder (OCSD)2 3 4.
Pica in Psychiatric Disorders
Obsessive-Compulsive Disorder (OCD) and Pica
Several studies suggest a strong association between pica and obsessive-compulsive disorder (OCD). Pica behaviors in adults have been linked to stress and are often described as impulsive or compulsive in nature3. Treatment with selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and escitalopram has shown significant improvement in pica symptoms, indicating a possible overlap with OCD2 3.
Schizophrenia and Pica
Pica is also observed in patients with schizophrenia, often linked to delusional beliefs. For instance, a case study described a schizophrenic patient who ingested non-food substances due to delusions that these items provided energy and improved vision4. Another case highlighted the exacerbation of pica as a precursor to psychosis, suggesting that worsening pica behaviors could indicate an upcoming psychotic episode5. Long-term schizophrenia patients with pica often face severe medical complications such as intestinal obstruction and metal poisoning due to their eating behaviors6 7.
Medical and Psychological Implications
Pica can lead to serious medical consequences including intestinal obstruction, electrolyte imbalances, heavy metal toxicity, and parasitic infections1 4 7. The disorder is more common in areas of low socioeconomic status and among women and children8. In pediatric patients with conditions like sickle cell disease, pica behaviors are prevalent and can complicate the management of the primary disease9.
Treatment Approaches
Treatment for pica often involves addressing the underlying psychiatric or medical conditions. SSRIs have been effective in treating pica associated with OCD and depression2 3. Behavioral interventions, family education, and psychotherapy are also crucial in managing pica, especially in patients with severe psychiatric disorders like schizophrenia7.
Conclusion
Pica is a complex psychological disorder with multifaceted etiologies and significant medical and psychological implications. Its association with psychiatric disorders such as OCD and schizophrenia underscores the need for comprehensive treatment approaches that address both the psychological and medical aspects of the disorder. Further research is essential to better understand the mechanisms of pica and to develop more effective management strategies.
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Most relevant research papers on this topic
Pica in various psychiatric disorders
Pica can be caused by various psychiatric disorders, nutritional deficiencies, and interpersonal conflicts, and can be significantly improved with antidepressant medication.
Case ReportIs Pica an eating disorder or an obsessive–compulsive spectrum disorder?
Pica is a nonnutritive eating disorder that can be successfully treated with fluoxetine in children, suggesting its potential as a treatment for psychiatric disorders.
Case ReportPica responding to SSRI: An OCD spectrum disorder?
Stress may induce pica in adults, and SSRIs and stress management can help alleviate the symptoms.
Case ReportDisordered Eating Behavior in a Schizophrenic Patient: a Case of Pica.
Pica in a schizophrenic patient is linked to delusional beliefs that objects provide energy and better vision, but does not involve suicidal behavior.
Case Report
Rigorous JournalExacerbation of pica as a precursor of psychosis
Exacerbation of pica can be a precursor to psychosis and can serve as an indicator for an upcoming psychotic episode, potentially aiding early identification and treatment.
Case ReportCase report: An unusual case of pica
Pica is a persistent, culturally and developmentally inappropriate ingestion of non-nutritive substances, often related to cognitive deficits and hyperoral behavior.
Case ReportSevere pica in long-term schizophrenia, a case report
Pica can become a highly dysfunctional syndrome in patients with long-term schizophrenia, leading to severe organic and life impacts.
Case ReportRigorous JournalPica: Common but Commonly Missed
Pica is a common but often overlooked condition, affecting low socioeconomic status individuals and causing complications like iron-deficiency anemia, lead poisoning, and helminthic infestations.
Systematic Review
Highly CitedPica behaviors in pediatric patients with sickle cell disease: A scoping review protocol.
Pediatric patients with sickle cell disease often experience pica behaviors, requiring targeted interventions and supportive care to prevent harmful complications.
Systematic ReviewPrevalence of pica and rumination behaviors in German children aged 7–14 and their associations with feeding, eating, and general psychopathology: a population-based study
Pica and rumination behaviors are prevalent in children aged 7-14, with recurrence rates significantly increased in the presence of avoidant/restrictive food intake disorder, and both behaviors negatively correlated with prosocial behavior.
Observational Study
Very Rigorous Journal