Pica (disorder)

Pica
Stomach contents of a psychiatric patient with pica: 1,446 items, including "457 nails, 42 screws, safety pins, spoon tops, and salt and pepper shaker tops".
Pronunciation	/ˈpaɪkə/ PY-kuh[1]
Specialty	Psychiatry
Duration	Entire lifespan
Causes	Anemia Autism Culture-bound syndrome Malnutrition Schizophrenia
Deaths	86,399

Pica is the eating or craving of things that are not food.^[2] It is classified as an eating disorder but can also be the result of an existing mental disorder.^[3] The ingested or craved substance may be biological, natural or manmade. The term was drawn directly from the medieval Latin word for magpie, a bird subject to much folklore regarding its opportunistic feeding behaviors.^[4]

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), pica as a standalone eating disorder must persist for more than one month at an age when eating such objects is considered developmentally inappropriate, not part of culturally sanctioned practice, and sufficiently severe to warrant clinical attention. Pica may lead to intoxication in children, which can result in an impairment of both physical and mental development.^[5] In addition, it can cause surgical emergencies to address intestinal obstructions, as well as more subtle symptoms such as nutritional deficiencies and parasitosis.^[5] Pica has been linked to other mental disorders. Stressors such as psychological trauma, maternal deprivation, family issues, parental neglect, pregnancy, and a disorganized family structure are risk factors for pica.^[5][6]

Pica is most commonly seen in pregnant women,^[7] small children, and people who may have developmental disabilities such as autism.^[8] Children eating painted plaster containing lead may develop brain damage from lead poisoning. A similar risk exists from eating soil near roads that existed before the phase-out of tetraethyllead or that were sprayed with oil (to settle dust) contaminated by toxic PCBs or dioxin. In addition to poisoning, a much greater risk exists of gastrointestinal obstruction or tearing in the stomach. Another risk of eating soil is the ingestion of animal feces and accompanying parasites. Cases of severe bacterial infections occurrence (leptospirosis) in patients diagnosed with pica have also been reported.^[9] Pica can also be found in animals such as dogs^[10] and cats.^[11]