Although prevalence rates vary depending on the definition of pica, the characteristics of the population sampled, and the methods used for data collection, pica is reported most commonly in children and in individuals with mental retardation. In the US: Prevalence of pica is unknown because the disorder often is unrecognized and underreported.Gastrointestinal (GI) tract complications, including mechanical bowel problems, constipation, ulcerations, perforations, and intestinal obstructions, have resulted from pica. In particular, geophagia (soil or clay ingestion) has been associated with soil-borne parasitic infections, such as toxoplasmosis and toxocariasis. The ingestion of bizarre or unusual substances also has resulted in other potentially life-threatening toxicities, such as hyperkalemia following cautopyreiophagia (ingestion of burnt match heads).Įxposure to infectious agents via ingestion of contaminated substances is another potential health hazard associated with pica, the nature of which varies with the content of the ingested material. Pica has been shown to be a predisposing factor in accidental ingestion of poisons, particularly in lead poisoning. The nature and amount of the ingested substance determine the medical sequelae. Pica is a serious behavioral problem because it can result in significant medical sequelae. Furthermore, the pica must last for a period of at least 1 month. In such patients, pica typically is considered to be a secondary diagnosis. If pica is associated with mental retardation or pervasive developmental disorder, it must be sufficiently severe to warrant independent clinical attention. Consider pica when the behavior is inappropriate to the developmental level of the individual, is not part of a culturally sanctioned practice, and does not occur exclusively during the course of another mental disorder (eg, schizophrenia). In children aged 18 months to 2 years, the ingestion and mouthing of nonnutritive substances is common and is not considered to be pathologic. Pica may be benign, or it may have life-threatening consequences.
In some societies, pica is a culturally sanctioned practice and is not considered to be pathologic. Individuals presenting with pica have been reported to mouth and/or ingest a wide variety of nonfood substances, including, but not limited to, clay, dirt, sand, stones, pebbles, hair, feces, lead, laundry starch, vinyl gloves, plastic, pencil erasers, ice, fingernails, paper, paint chips, coal, chalk, wood, plaster, light bulbs, needles, string, and burnt matches.Īlthough pica is observed most frequently in children, it is the most common eating disorder seen in individuals with developmental disabilities. The definition occasionally is broadened to include the mouthing of nonnutritive substances. Pica is an eating disorder typically defined as the persistent eating of nonnutritive substances for a period of at least 1 month at an age in which this behavior is developmentally inappropriate (eg, >18-24 mo).
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