OVERVIEW

What is pica?

Pica is an eating disorder characterized by the persistent (lasting more than one month) consumption of non-nutritive, non-food substances such as dirt, paint, hair, soap, leaves, etc. These behaviors are inconsistent with the child's developmental level, not culturally sanctioned, and not attributable to other mental disorders.

Parents may feel ashamed or guilty when their child has pica, experiencing emotional distress. It is crucial for parents to build confidence and seek medical treatment for their child as early as possible. Additionally, relatives and friends should offer understanding and care, interacting with them without prejudice, respecting their privacy, and avoiding spreading personal information.

Are children common among pica patients?

Pica predominantly occurs in infants and young children, while older children and adolescents are less affected. Limited epidemiological data exists on pica, but some reports indicate that approximately 15% of children aged 2–3 exhibit pica behaviors.

SYMPTOMS

What are the main symptoms of pica?

• The main symptom is the consumption of non-nutritive substances by children, such as plaster, paper, paint, clothing, hair, animal feces, soil, sand, stones, dirt, etc.

• On the other hand, pica behavior often leads to complications that affect children's health, with some severe cases potentially life-threatening. These include anemia, diarrhea, constipation, parasitic infections, toxoplasmosis, lead poisoning, nutritional deficiencies, intestinal obstruction, etc. The type of complication depends on the ingested substance. For example, eating paint may cause lead poisoning, consuming feces or soil may lead to parasitic infections, clay ingestion may result in anemia and zinc deficiency, starch consumption may cause iron deficiency, and eating hair or stones may lead to intestinal obstruction.

• As children grow older, pica tends to gradually resolve, with most cases lasting several months. However, a minority may persist into adolescence or even adulthood. Some patients may experience delayed psychological development, and about half of adolescents may develop depression, personality disorders, or substance abuse.

CAUSES

What are the causes of pica?

The exact etiology and pathogenesis remain unclear. Current research suggests that nutritional deficiencies (such as iron, zinc, and calcium deficiency), poverty, chaotic family environments, lack of effective parental supervision, neglect and abuse, emotional deprivation, psychological cravings for non-nutritive substances, and dysfunctional family dynamics may contribute to the development of pica.

Is pica caused by a nutritional deficiency?

Pica may be associated with zinc deficiency in the body.

Clinical analyses of pica in zinc-deficient children indicate that symptoms disappear significantly after zinc supplementation.

Patients with pica can increase zinc intake by incorporating zinc-rich foods like lean meat, eggs, fish, nuts (e.g., walnuts, peanuts) into their diet to alleviate symptoms.

DIAGNOSIS

How is pica diagnosed?

The main diagnostic criteria for pica include:

• The child frequently consumes non-nutritive substances, such as dirt, paint, debris, hair, sand, stones, etc.;

• Repeated pica behavior, occurring at least twice a week for over 1 month;

• The behavior is not socially or culturally acceptable;

• Other mental disorders (e.g., schizophrenia, intellectual disability) causing the behavior must be ruled out;

• It may be accompanied by complications like anemia, parasitic infections, lead poisoning, nutritional deficiencies, or intestinal obstruction.

TREATMENT

How to treat pica?

• Psychological therapy is the main approach, while actively treating and managing complications, especially those that are life-threatening and require immediate attention.

• Psychological therapy primarily includes mental health education and behavioral therapy. Behavioral therapy can effectively improve pica behavior, with aversion therapy being a commonly used and fast-acting method. This may involve mild electric shocks, unpleasant sounds, or emetic drugs.

DIET & LIFESTYLE

None.

PREVENTION

None.