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Mental Health

Pica 

Pica is a psychological disorder characterized by an appetite for non-nutritive substances.

  • Common problem in children < 5 yr of age

 DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition)

  1. Patient must have been eating non-nutritive non-foods for at least one month.
  2. This eating must be considered abnormal for the person’s stage of development.
  3. Eating these substances cannot be associated with a cultural practice that is considered normal in the social context of the individual.
  4. For people who currently have a medical condition (e.g.: pregnancy) or a mental disorder (e.g.: autism spectrum disorder) the action of eating non-nutritive non-foods should only be considered pica if it is dangerous and requires extra medical investigation or treatment on top of what they are already receiving for their pre-existing condition.

Aetiology

  • Factors speculated to predispose to pica:
    • Mental retardation
    • Psychosocial stress (maternal deprivation, parental neglect and abuse)
    • Other behavioral disorders

Complications

  • Intestinal obstruction
  • Nutritional deficiencies
  • Poisoning
  • Parasitosis

Management

  • Behaviour modification
  • Alleviating psychosocial stress (if present)
  • Iron deficiency:
    • Iron supplementation

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