Pica resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[2]
Overview
Pica is defined as the compulsive craving for or eating non-nutritive or non-food substances for at least a period of one month[1]. Pica maybe a part of a cultural phenomenon, during childhood, in persons or children who are mentally disabled or even in pregnancy. Iron deficiency anemia is also an important cause of pica. Pica is treated by a multifocal approach which includes reduction of cravings, addressing the social and emotional issues faced by the individual and treating the anemia if present. Pica is further divided based on the type of substance ingested such as ice, lead, feces, soil etc.
Causes
- Pica is commonly seen in children over 2 years of age.
- Iron deficiency anemia
- Pregnancy
- Autism and other developmental disabilities
- Lower socioeconomic status
- Epilepsy
- Schizophrenia
- Recently, obsessive compulsive disorder has also been implicated as a cause [2].
Diagnosis
- The diagnosis of pica includes a detailed history and physical examination, appropriate laboratory investigations.
Management
Do's
Dont's
- ↑ Leung AKC, Hon KL (2019). "Pica: A Common Condition that is Commonly Missed - An Update Review". Curr Pediatr Rev. 15 (3): 164–169. doi:10.2174/1573396315666190313163530. PMID 30868957.
- ↑ Hergüner S, Ozyildirim I, Tanidir C (2008). "Is Pica an eating disorder or an obsessive-compulsive spectrum disorder?". Prog Neuropsychopharmacol Biol Psychiatry. 32 (8): 2010–1. doi:10.1016/j.pnpbp.2008.09.011. PMID 18848964.
- ↑ Hoek HW, van Elburg AA (2014). "[Feeding and eating disorders in the DSM-5]". Tijdschr Psychiatr. 56 (3): 187–91. PMID 24643829.
Obtain a detailed history: ❑ Duration of symptoms ❑ What is the substance being ingested? ❑ When does the patient exhibit this behaviour? ❑ Is it during periods of emotional or physical stress? What is the source of the substance? According to the DSM5, the following 5 criteria must be met to diagnose someone with pica[3]: ❑ Person must be eating non-nutritive or non-food substances for at least one month. ❑ This behaviour must be considered abnormal for their stage of development. ❑ This behaviour must not be considered as a part of a cultural practice, and should be normal in the social context of that person. ❑ For a person with an existing condition like mental disability or pregnancy, this behaviour is considered as pica only when it is dangerous or requires medical investigations and attention. | |||||||||||||||||||||||||