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pica

 
Medical Encyclopedia: Pica
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Definition

Pica is the persistent craving and compulsive eating of non-food substances.

Description

The puzzling phenomenon of pica has been recognized and described since ancient times. Pica has been observed in ethnic groups worldwide, in both primitive and modernized cultures, in both sexes, and in all age groups. The word pica comes from the Latin name for magpie, a bird known for its unusual and indiscriminate eating habits. In addition to humans, pica has been observed in other animals, including the chimpanzee.

Pica in humans has many different subgroups, defined by the substance that is ingested. Some of the most commonly described types of pica are eating earth, soil or clay (geophagia), ice (pagophagia) and starch (amylophagia). However, pica involving dozens of other substances, including cigarette butts and ashes, hair, paint chips, and paper have also been reported.

Although pica can occur in individuals of any background, a higher incidence of pica is associated with:

— Stefanie B. N. Dugan, MS


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Dictionary: pi·ca1   (pī'kə) pronunciation
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n.
    1. A printer's unit of type size, equal to 12 points or about 1/6 of an inch.
    2. An equivalent unit of composition measurement used in determining the dimensions of lines, illustrations, or printed pages.
  2. A type size for typewriters, providing ten characters to the inch.

[Probably from Medieval Latin pīca, list of church services (perhaps from the typeface used to print it).]


pi·ca2 (pī'kə) pronunciation
n.
An abnormal craving or appetite for nonfood substances, such as dirt, paint, or clay.

[New Latin pīca, from Latin, magpie (from its omnivorous nature).]


Computer Desktop Encyclopedia: pica
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(1) In word processing, a monospaced font that prints 10 characters per inch.

(2) In typography, about 1/6th of an inch (0.166") or 12 points.

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Marketing Dictionary: pica
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Home > Library > Business & Finance > Marketing Dictionary

1. Unit of measure used in composition equal to 1/6th of an inch.

2. 12 points.

3. Typewriter type font measuring 10 characters to the inch. See also elite.

Food and Nutrition: pica
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Home > Library > Food & Cooking > Food and Nutrition

An unnatural desire for foods; alternative words are cissa, cittosis, and allotriophagy. Also a perverted appetite (eating of earth, sand, clay, paper, etc.).

Food and Fitness: pica
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A craving for substances not normally considered to be nutrients. The curious behaviour of some pregnant women who crave for ice (pagophagia) or eat mouthfuls of clay (geophagia) may be caused by a real need for extra minerals, especially iron and zinc. If pica is due to a mineral deficiency, it clears up very quickly after the appropriate mineral supplement is taken.

Dental Dictionary: pica
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Home > Library > Health > Dental Dictionary
(pī'kə)
n

A persistent, pathologic desire to eat nonfood items such as paper or dirt.

Children's Health Encyclopedia: Pica
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Home > Library > Health > Children's Health Encyclopedia

Definition

Pica is the persistent craving and compulsive eating of non-food substances.

Description

The puzzling phenomenon of pica has been recognized and described since ancient times. Pica has been observed in ethnic groups worldwide, in both primitive and modernized cultures, in both sexes, and in all age groups. The word pica comes from the Latin name for magpie, a bird known for its unusual and indiscriminate eating habits. In addition to humans, pica has been observed in other animals, including the chimpanzee.

Demographics

True pica affects people of all ages, although it is more common in children. There are some regional variations concerning specific substances. For example, eating clay is more prevalent among women in the American southeast than in other areas of the country. Adolescents may chew ice due to peer pressure or because they are deficient in iron. Without a blood test for serum iron, there is no way to differentiate these causes.

Causes and Symptoms

Pica in humans has many different subgroups, defined by the substance that is ingested. Some of the most commonly described types of pica are eating earth, soil, or clay (geophagia); ice (pagophagia); and starch (amylophagia). However, pica involving dozens of other substances, including cigarette butts and ashes, hair, paint chips, and paper have also been reported.

Although pica can occur in individuals of any background, a higher incidence of pica is associated with:

  • pregnancy
  • developmental disabilities
  • mental retardation
  • psychiatric disease and autism
  • early childhood (under age three)
  • poor nutrition or low blood levels of iron and other minerals
  • certain cultural or religious traditions

When to Call the Doctor

A health care professional should be consulted whenever a child over the age of three repeatedly ingests non-food substances for a period over one month. The behavior might be merely habitual, but it can become a compulsion that needs treatment.

Diagnosis

In order for the diagnosis of pica to be made, there must be a history of persistent consumption of a non-food substance continuing for a minimum period of one month. Infants and toddlers are typically excluded from this diagnosis since mouthing objects is a normal developmental behavior at that age. Individuals with mental retardation who function at or below an approximate cognitive level of 18 months may also be exempt from this diagnosis.

Pica is most often diagnosed when a report of such behaviors can be provided by an individual or documented by another person. In other cases, pica is diagnosed after studies have been performed to assess the presenting symptoms. For example, imaging studies ordered to assess severe gastrointestinal complaints may reveal intestinal blockage with an opaque substance; such a finding is suggestive of pica. Biopsy of intestinal contents can also reveal findings, such as parasitic infection, consistent with pica. Pica may also be suspected if abnormal levels of certain minerals or chemicals are detected in the blood.

Treatment

Treatment of pica will often depend on the cause and type of pica. Conventional medical treatment may be appropriate in certain situations. For example, supplementation with iron-containing vitamins has been shown to cause the unusual cravings to subside in some iron-deficient people.

Medical complications and health threats, including high lead levels, bowel perforation or intestinal obstruction, will require additional medical management, beyond addressing the underlying issue of pica.

Because most cases of pica do not have an obvious medical cause, treatment with counseling, education, and nutritional management is often more successful and more appropriate than treatment with medication. Some therapists specializing in eating disorders may have expertise in treating pica.

Prognosis

The prognosis for individuals with pica varies greatly, according to the type and amount of substance ingested, the extent of presenting side effects, and the success of treatment. Many of the side effects and complications of pica can be reversed once the behavior is stopped, while other complications, including infection and bowel perforation, pose significant health threats and if not successfully treated may result in death.

When seen in children, pica behavior tends to lessen with age. However, individuals with a history of pica are more likely to experience it again. Counseling and nutritional education can reduce the risk of recurrence.

Prevention

There are no known methods of preventing pica. However, once pica is known or suspected, measures can be taken to reduce further ingestion of non-food substances. Removing the particular substance from readily accessible areas can be helpful. Close observation of the individual with pica may limit inappropriate eating behaviors.

Nutritional Concerns

Pica may be a symptom of an underlying nutritional deficiency. Correcting the deficiency usually stops the pica.

Parental Concerns

Parents should monitor the food and other substances that their children eat. Repeated ingestion of non-food substances may be cause for concern. An evaluation by a pediatrician is recommended in such circumstances. Parents should be especially careful of children who eat paint chips, because this can cause lead poisoning if the paint is from an older home in which lead paint was used.

Resources

Books

Heird, William C. "Food Insecurity, Hunger and Undernutrition." In Nelson Textbook of Pediatrics. 17th ed. Ed. by Richard E. Behrman, et al., Philadelphia: Saunders, 2003, 167-172.

Matthews, Dawn D. Eating Disorders SourceBook Detroit, MI: Omnigraphics, Incorporated, 2001.

Walsh, B. Timothy. "Eating Disorders." In Harrison'sPrinciples of Internal Medicine. 15th ed. Ed. by Eugene Braunwald et al., New York, McGraw Hill, 2001, 486-90.

West, Delia S. "Eating Disorders." In Cecil Textbook of Medicine. 22nd ed. Ed. by Lee Goldman, et al. Philadelphia: Saunders, 2003, 1336–8.

Periodicals

Dreyer MJ, Chaushev PG, and Gledhill RF. "Biochemical investigations in geophagia." Journal of the Royal Society of Medicine 97, no. 1 (2004): 48-53.

Kuhn DE and Matson JL. "Assessment of feeding and mealtime behavior problems in persons with mental retardation." Behavior Modification 28, no. 5 (2004): 638–48.

Lavoie PM and Bailey B. "Lead poisoning from "lead-free" paint." Canadian Medical Association Journal 170, no. 6 (2004): 956–8.

Moya J, Bearer CF, and Etzel RA. "Children's behavior and physiology and how it affects exposure to environmental contaminants." Pediatrics 113, no. 4 Supplement (2004): 996–1006.

Organizations

National Eating Disorders Organization (NEDO). 6655 South Yale Ave, Tulsa, OK 74136. (918) 481-4044. Hotline: (800) 931.2237. Web site: www.NationalEatingDisorders.org.

Other

"Children and Eating Disorders." Vanderbilt University. Available online at www.vanderbilt.edu/AnS/psychology/health_psychology/childrenandED.html.

"Eating Disorder: Pica." eMedicine. Available online at www.emedicine.com/ped/topic1798.htm.

"Eating Disorders." Encyclopedia.Com. Available online at www.encyclopedia.com/html/e1/eatingdi.asp.

"Pica." Web MD Health. Available online at .

[Article by: L. Fleming Fallon, Jr., MD, DrPH]


Measures and Units: pica
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paper and printing British One specific size or, when qualified, one of two else more sizes of a type body size, of height 11 points for small pica, 12 for pica, plus various fractions and multiples. Also used, in the sense of the pica em, to mean virtually ⅙ in(4.233~ mm). Applied to a typewriter of fixed pitch, it refers to a type size equivalent to pica, with 6 lines per inch and, horizontally, 10 characters per inch; compare elite.

Science Q&A: What is pica?
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Pica refers to the craving for unnatural or non-nutritious substances. It is named after the magpie (Pica pica), which has a reputation for sticking its beak into all kinds of things to satisfy its hunger or curiosity. It can happen in both sexes, all races, and in all parts of the world, but is especially noted in pregnant women.

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Wikipedia: Pica (disorder)
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This article is about the medical disorder. For other uses, see Pica.
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Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (July 2007)
Pica (disorder)
Classification and external resources

Stomach contents of a psychiatric inmate with pica
ICD-10 F50.8, F98.3
ICD-9 307.52
DiseasesDB 29704
eMedicine ped/1798
MeSH D010842

Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g., clay, coal, soil, feces, chalk, paper, soap, mucus, ash, gum etc.) or an abnormal appetite for some things that may be considered foods, such as food ingredients (e.g., flour, raw potato, raw rice, starch, ice cubes, salt).[1] In order for these actions to be considered pica, they must persist for more than one month at an age where eating such objects is considered developmentally inappropriate. The condition's name comes from the Latin word for magpie, a bird which is reputed to eat almost anything.[2] Pica is seen in all ages, particularly in pregnant women, small children, and those with developmental disabilities.

Pica in children, while common, can be dangerous. Children eating painted plaster containing lead may suffer brain damage from lead poisoning. There is a similar risk from eating dirt near roads that existed prior to the phaseout of tetra-ethyl lead in gasoline (in some countries) or prior to the cessation of the use of contaminated oil (either used, or containing toxic PCBs or dioxin) to settle dust. In addition to poisoning, there is also a much greater risk of gastro-intestinal obstruction or tearing in the stomach[citation needed]. This is also true in animals. Another risk of dirt eating is the possible ingestion of animal feces and the accompanying parasites. Pica can also be found in animals, and is most commonly found in dogs.

Contents

Causes

The scant research that has been done on the causes of pica suggests that the disorder is caused by mineral deficiency in many cases, typically iron deficiency which is sometimes a result of celiac disease.[3] Often the substance eaten by someone with pica contains the mineral in which that individual is deficient. More recently, cases of pica have been tied to the obsessive–compulsive spectrum, and there is a move to consider OCD in the etiology of pica[4]; however, pica is not currently recognised by the widely used Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as being a mental disorder. Sensory, physiological, cultural, and psychosocial perspectives have also been used by some to explain the causation of pica.

Pica may also be a symptom of iron deficiency anemia secondary to hookworm infection.[citation needed] Symptoms may also include a bluish hue to the skin, particularly around the mouth[citation needed].

Few studies have been conducted to measure the prevalence of pica in various populations. Two prevalence studies conducted on pregnant women in the 1990s found rates of 8.1% for pregnant African American women in the U.S.[5] and 8.8% for pregnant women in Saudi Arabia.[6] Rates of pica among pregnant women in developing countries can be much higher, however, with estimates of 63.7%[7] and 74.0%[8] reported for two different African populations. This is due to different cultural norms as well as greater levels of malnutrition. Two studies of mentally retarded adults living in institutions found that 21.8%[9] and 25.8%[10] of these groups suffered from pica. Prevalence rates for children with and without developmental disabilities are unknown.

Unlike in humans, in dogs or cats, pica may be a sign of immune-mediated hemolytic anemia, especially when it involves eating substances such as tile grout, concrete dust, and sand. Dogs exhibiting this form of pica should be tested for anemia with a CBC or at least hematocrit levels.[11][12]

Treatment

Treatment for pica will vary based on the patient's category (child, developmentally disabled, pregnant, or psychopathic) and may emphasize psychosocial, environmental, and family guidance approaches. An initial approach often involves screening for and, if necessary, treating any mineral deficiencies or other comorbid conditions.[3] For pica that appears to be of psychotic etiology, therapy and medication such as SSRIs have been used successfully.[13] However, previous reports have cautioned against the use of medication until after all non-psychotic etiologies have been ruled out.[14]

Some 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[citation needed]. These medications enhance dopaminergic functioning, which is believed to be associated with the occurrence of pica[citation needed].

Behavior-based treatment options can be useful for developmentally disabled or mentally retarded individuals with pica. These may involve associating negative consequences with eating non-food items or good consequences with normal behavior, and may be contingent on pica being attempted or initiated regardless of a pica attempt. A recent study classified nine such classes of behavioral intervention[15]:

  • Presentation of attention, food, or toys, not contingent on pica being attempted
  • Differential reinforcement, with positive reinforcement if pica is not attempted and negative reinforcement if pica is attempted
  • Discrimination training between edible and inedible items, with negative consequences if pica is attempted
  • Visual screening, with eyes briefly for a short time after pica is attempted
  • 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)
  • Physical restraint:
    • 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 (nonedible object held against patient's mouth without allowing ingestion)

Examples

Chalky stone composed of kaolinite with traces of quartz ingested by a patient with pica.

Popular culture

  • A patient suffering from pica was featured in the season four premiere of Grey's Anatomy.
  • Jimmy Kimmel has suggested several times in his stand-up that G. Gordon Liddy suffers from pica and, as such, may have been Deep Throat.
  • In the House episode "Lines in the Sand", a severely autistic boy with pica is diagnosed with raccoon roundworms that he acquired from eating the sand in his sandbox.
  • In an interview with David Letterman, actress Kristen Bell deduced that her pet dog may have pica.
  • In the 2004 film Undertow a young boy suffers from pica.
  • In Law & Order: Special Victims Unit episode "Lead", the character Jeff Lynwood, played by John Gallagher, Jr., is found to have pica when he is seen eating a pencil while on trial.
  • The character Rebeca from the novel 100 Years of Solitude by Gabriel Garcia Marquez, has a condition similar to pica, where she eats whitewash and soil.
  • In Season 5, Episode 21 ("Committed") of CSI: Crime Scene Investigation the victim is postulated to be suffering from pica by Gil Grissom.
  • Pica was the 756th way to die in the U.S. T.V. Series, 1000 Ways to Die
  • The novel White is for Witching by Helen Oyeyemi features a character suffering from pica.
  • In the Season One Premier of Three Rivers (TV Series) a 14 year old boy was featured suffering from pica.
  • In the animated film Grave of the Fireflies, one of the protagonists, Setsuko, suffers from pica after being malnourished.

Notes

  1. ^ emedince.com article on "Eating Disorder: Pica"
  2. ^ http://www.wenwen.ws/bird/Birds/crows-and-magpies-whats-their-favourite-food-f5wg02698.htm
  3. ^ a b Rose, E.A., Porcerelli, J.H., & Neale, A.V. (2000). "Pica: Common but commonly missed". The Journal of the American Board of Family Practice 13 (5): 353-358.  PMID 11001006
  4. ^ Hergüner, S., Ozyildirim, I., & Tanidir, C. (2008). "Is Pica an eating disorder or an obsessive-compulsive spectrum disorder?". Progress in Neuro-Psychopharmacology & Biological Psychiatry 32 (8): 2010–2011.  PMID 18848964
  5. ^ Edwards, C.H., Johnson, A.A., Knight, E.M., Oyemade, U.J., Cole, O.J., Westney, O.E., et al. (1994). "Pica in an urban environment". The Journal of Nutrition 124 (6 Suppl): 954S-962S.  PMID 8201446
  6. ^ al-Kanhal, M.A., & Bani, I.A. (1995). "Food habits during pregnancy among Saudi women". International Journal for Vitamin and Nutrition Research 65 (3): 206-210.  PMID 8830001
  7. ^ Nyaruhucha, C.N. (2009). "Food cravings, aversions and pica among pregnant women in Dar es Salaam, Tanzania". Tanzania Journal of Health Research 11 (1): 29-34.  PMID 19445102
  8. ^ Ngozi, P.O. (2008). "Pica practices of pregnant women in Nairobi, Kenya". East African Medical Journal 85 (2): 72-79.  PMID 18557250
  9. ^ Ashworth, M., Hirdes, J.P., & Martin, L. (2009). "The social and recreational characteristics of adults with intellectual disability and pica living in institutions". Research in Developmental Disabilities 30 (3): 512-520.  PMID 18789647
  10. ^ Danford, D.E., & Huber, A.M. (1982). "Pica among mentally retarded adults". American Journal of Mental Deficiency 87 (2): 141-146.  PMID 7124824
  11. ^ Plunkett, Signe J. (2000). Emergency Procedures for the Small Animal Veterinarian. Elsevier Health Sciences. pp. 11. ISBN 0702024872. 
  12. ^ Feldman, Bernard F.; Joseph G. Zinkl, Nemi Chand Jain, Oscar William Schalm (2000). Schalm's Veterinary Hematology. Blackwell Publishing. pp. 506. ISBN 0683306928. 
  13. ^ Bhatia, M.S., & Gupta, R. (2007-05-11). "Pica responding to SSRI: An OCD spectrum disorder?". The World Journal of Biological Psychiatry.  Online publication ahead of print. PMID 17853279
  14. ^ Fotoulaki, M., Panagopoulou, P., Efstratiou, I., & Nousia-Arvanitakis, S. (2007). "Pitfalls in the approach to pica". European Journal of Pediatrics 166 (6): 623-624.  PMID 17008997
  15. ^ McAdam, D.B., Sherman, J.A., Sheldon, J.B., & Napolitano, D.A. (2004). "Behavioral interventions to reduce the pica of persons with developmental disabilities". Behavior Modification 28 (1): 45-72.  PMID 14710707
  16. ^ Why Kenyan women crave stones BBC News

External links



This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

Translations: Pica
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Dansk (Danish)
1.
n. - måleenhed for skrifttypestørrelse og linjelængde

2.
n. - pica

Nederlands (Dutch)
pica (typografische eenheid), cicero (drukletter), drang om oneetbare substanties te eten

Français (French)
1.
n. - (Imprim) cicéro

2.
n. - (Méd) pica

Deutsch (German)
1.
n. - Pica (Schriftgrad)

2.
n. - Pika (unnatürliches Eßgelüst)

Ελληνική (Greek)
n. - (τυπογρ.) στοιχείο των 12 στιγμών, "δωδεκάρι"

Italiano (Italian)
corpo tipografico, corpo 12

Português (Portuguese)
n. - paica (f), pica (f) (Med.)

Русский (Russian)
цицеро

Español (Spanish)
1.
n. - pica, císero

2.
n. - pica, malacia

Svenska (Swedish)
n. - 12 punkt stilrad, typstorlek (boktr.)

中文（简体）(Chinese (Simplified))
1. 12磅因的活字, 打字机之字体

2. 异食癖

中文（繁體）(Chinese (Traditional))
1.
n. - 12磅因的活字, 打字機之字體

2.
n. - 異食癖

한국어 (Korean)
1.
n. - 파이카(12 포인트 활자, 타이프에 씀), 예식 규칙집

2.
n. - 이식증

日本語 (Japanese)
n. - パイカ

العربيه (Arabic)
‏(الاسم) حرف مطبعي من حجم إثنى عشر بنطا‏

עברית (Hebrew)
n. - ‮יחידת-מידה לאות דפוס (5.4 מ"מ), 01 אותיות לאינטש בהקלדה, תיאבון מעוות (לדברים לא אכילים)‬
n. - ‮תיאבון מעוות (לדברים לא אכילים)‬

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