Pica is a pattern of eating non-nutritive substances (such as dirt or paper), lasting for at least one month.
Causes, incidence, and risk factors
Pica is seen more in young children than adults, with 10 to 32% of children age one to six years old exhibiting these behaviors. Pica can occur during pregnancy . In some cases, specific nutritional deficiencies, such as iron deficiency anemia and zinc deficiency, may trigger the unusual cravings. Pica may also occur in adults who crave a certain texture in their mouth.
Signs and tests
There is no single test that confirms pica. However, since pica is associated with abnormal nutritient levels, and in some cases malnutrition , several tests may be performed. Serum levels of iron and zinc should be taken. Hemoglobin should also be checked to test for anemia . Lead levels should always be checked in children, who may have eaten paint or objects covered in lead paint dust. The presence of infection may be detected, if contaminated soil or animal waste is being ingested.
Treatment
Identified nutritional deficiencies and other problems, such as lead toxicity, should be addressed medically. Treatment emphasizes psychosocial, environmental, and family guidance approaches. Other successful treatments have been mild aversion therapy followed by positive reinforcement. This involves associating bad consequences with eating non-food items and good consequences with normal behavior. Medications may be helpful in reducing the abnormal eating behavior, if pica occurs in the course of a developmental disorder, such as mental retardation, or pervasive developmental disorder. These conditions may be associated with severe behavioral disturbances, including pica.
Expectations (prognosis)
Treatment success varies. In many cases, the disorder lasts several months, then resolves spontaneously. In some cases, it may continue into adolescence or adulthood, particularly when associated with developmental disorders.
Prevention
There is no specific prevention. Adequate nutrition may be helpful.