Pica

An hunger for mostly non-nutritive items like ice, paper, clay, drywall, paint, metal, chalk, soil, glass, or sand is a characteristic of pica. It can cause youngsters to become intoxicated, which can damage their physical and mental development. Additionally, it might result in more subdued symptoms such dietary deficits and parasitosis as well as surgical emergency because of an intestinal obstruction. Pica has been connected to other emotional and mental illnesses. Pica is significantly associated with stressors such emotional trauma, maternal deprivation, family problems, parental neglect, pregnancy, and an unorganized family structure.

Pregnant women, young children, and those with developmental disorders like autism are the groups who get pica the most frequently. Children who consume lead-contaminated painted plaster risk developing brain damage.

Causes

• Unknown
• Nutritional deficiencies
• Cultural and familial factors
• Stress
• Low socioeconomic status
• Parental neglect and history of neonatal insults
• Underlying biochemical disorder

Risk factors

• Family disorganization
• Environmental deprivation
• Epilepsy
• Brain damage
• Mental retardation

Clinical features

• Eating plaster, soil, insects, dirt, lead etc
• Anaemia
• Various parasitic infections
• Diarrhoea
• Constipation
• Lead toxicity

Diagnostic criteria

• Eating nonnutritive foods on a regular basis for at least one month.
• Neither satisfies the requirements for autism, schizophrenia, or Kleine-Levin syndrome.
• The eating habits are not accepted in the culture.
• If the eating behavior only manifests as a result of another mental disease (such as schizophrenia, pervasive developmental disorder, or intellectual disability), it is severe enough to require independent psychiatric attention.

Treatment

• There is no requirement that a pica be tried before attention, food, or toys be presented.
• Differential reinforcement, with benefits for refraining from pica attempts and negative reinforcement for those who do
• Training in edible and inedible item distinction, with harmful outcomes if pica is attempted
• After attempting pica, there will be a brief period of visual screening with the eyes covered.
• Aversive presentation, contingent on pica being attempted:
  • oral taste (e.g., lemon)
  • smell sensation (e.g., ammonia)
  • physical sensation (e.g., water mist in face)
• Self-protection devices that prohibit placement of objects in the mouth.
• Brief restraint contingent on pica being attempted.
• Time-out contingent on pica being attempted.
• Overcorrection, with attempted pica resulting in required washing of self, disposal of nonedible objects and chore-based punishment.
• Negative practice (non-edible object held against patient's mouth without allowing ingestion).

Complication

The chemical consumed could have complications. Hairballs can induce intestinal blockage, paint or paint-soaked plaster can cause lead poisoning, and eating excrement or dirt can result in toxoplasma or toxocara infections.