Lecture Notes on Pica

Introduction to Pica

• Pica is an eating disorder involving the craving and eating of non-nutritive, inedible objects.
• Common objects include rocks, paper, clay, and more.
• Associated with certain medical and psychiatric conditions.

Diagnostic Criteria (DSM-5)

• Persistent eating of non-nutritive objects over at least one month.
• Exclusion criteria:
  • Children below 24 months.
  • Cultural practices involving inedible consumption.
  • Certain psychiatric conditions, e.g., schizophrenia (unless Pica is severe).

Prevalence and Demographic Information

• Common in young children (25-33%).
• Decreases with age.

Common Items Consumed with Pica

• Rocks, pebbles, paper, clay, chalk, crayons, eggshells, coffee grounds, soap, hair, pet food.
• Specific types:
  • Geophagy: Eating dirt/soil.
  • Amylophagy: Eating raw starches (e.g., raw potatoes).

Possible Causes of Pica

• Not entirely understood.
• Nutritional Deficiencies: Iron, calcium, zinc.
• Hypothesis: Consumed substances may bind harmful toxins.

Medical Conditions Triggering Pica

• Iron Deficiency Anemia: Linked with pagophagy (craving ice).
• Sickle Cell Disease: Affects 34%, linked to hemoglobin levels and reticulocyte count.
• Pregnancy: More common in younger, late-adolescent females; often resolves postpartum.

Psychiatric Conditions

• Intellectual Disability: 10% prevalence, higher in severe cases, ages 10-20.
• Autism Spectrum: Often due to co-occurring intellectual disability.
• Other Conditions: Schizophrenia, trichotillomania, stress, and anxiety.

Complications of Pica

• Lead Poisoning: Most common in soil/dirt consumption.
• Infections: Parasitic (toxocariasis, ascariasis, toxoplasmosis).
• Small Bowel Obstruction: Due to bezoar formation.

Treatment Approaches

• Medical Treatment: Address underlying conditions (e.g., iron, zinc, calcium deficiencies).
• Multidisciplinary Approach: Behavioral management for psychiatric-related Pica.
  • Education on edible vs. inedible objects.
  • Habit reversal training.
  • Positive reinforcement.
  • Environmental enrichment.

Recommendations:

• Watch resources on related conditions like iron deficiency anemia and lead poisoning.
• Behavioral management techniques and interdisciplinary support are crucial in treatment.
• Subscribe to the educational channel for more lessons.