Pica

From Ask Dr Wiki

Key Criteria For Diagnosing PICA

Pica is defined as the ingestion of non nutrient based substances and is seen to occur in children as well as adults. In order to make the diagnosis according to DSM IV TR, the duration must be at least one month, the behavior must not be part of a culturally sanctioned practice AND it must be inappropriate for the developmental level of the child. Typical presentations of pica can be seen in persons with mental retardation as well as other developmental disorders, and severe anxiety disorders. Some women have cravings for non nutrient based substances during pregnancy. Prior to the third year of life, developing infants tend to explore their environment by putting objects of interest into their mouths. When this behavior persists, the most common form of pica seen in children - eating lead based paint chips - can lead to lead poisoning. This problem has significant long term sequelae and there are now programs in place to monitor the use of lead based paints in apartment buildings and serum lead levels are routinely checked for baseline by pediatricians. In spite of this, lead poisoning remains a significant issue and other sources have been identified including gasolines and contaminated soil, as well as lead soldered kettles and cans and lead glazed pottery which can release lead when foods containing acids are cooked in them. Other non nutritional substances ingested by persons with pica include paper, cloth, hair and strings. Some women ingest dry starch from the box during pregnancy.

Assessment of PICA

• Symptoms of pica

The symptoms of pica vary according to the substance ingested and the organ affected by it.

• Physical Examination
• Laboratory Data

Treatment of PICA

• Medications

• Behavioral Modification