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Current Neurology and Neuroscience... Aug 2022Pica is defined by the American Psychiatric Association's Diagnostic and Statistical Manual, 5th edition (DSM 5) as the ongoing ingestion of materials with no nutritive... (Review)
Review
PURPOSE OF REVIEW
Pica is defined by the American Psychiatric Association's Diagnostic and Statistical Manual, 5th edition (DSM 5) as the ongoing ingestion of materials with no nutritive or food value. More specifically such ingestions must be unremitting for at least 1 month and occur at a developmentally inconsistent age for such behavior. This article reviews the association of pica with pregnancy, micronutrient deficiencies, psychiatric disorders, dementia, and developmental disorders with emphasis on autism spectrum disorders (ASD).
RECENT FINDINGS
Some variants of non-nutritive consumption are prevalent behavioral norms in non-western cultures, so not all picas should be considered pathological. However, the strong association of pica with iron deficiency anemia (IDA) lends credence to the hypothesis that dopamine transmission may be disrupted in this disorder. Picas associated with ASD are resistant to medications but can be treated with applied behavioral analysis therapy (ABA). Etiological hypotheses for pica are explored with a focus on neurobiological, neuroimaging, and psychiatric correlations. Pharmacological management and behavior modification strategies are also discussed. The possibility that pica is a form of addiction analogous to food cravings is introduced and suggested as an area for further research pursuits.
Topics: Anemia, Iron-Deficiency; Autism Spectrum Disorder; Female; Humans; Neurology; Pica; Pregnancy; United States
PubMed: 35674869
DOI: 10.1007/s11910-022-01218-2 -
Pediatrics Feb 2021Pica, the repeated ingestion of nonfood items, can be life-threatening. Although case reports describe pica in children with autism spectrum disorder (ASD) or...
BACKGROUND AND OBJECTIVES
Pica, the repeated ingestion of nonfood items, can be life-threatening. Although case reports describe pica in children with autism spectrum disorder (ASD) or intellectual disability (ID), there has been little systematic study of pica prevalence. We assessed pica in children 30 to 68 months of age (median = 55.4 months) with and without ASD.
METHODS
Our sample from the Study to Explore Early Development, a multisite case-control study, included children with ASD ( = 1426), children with other developmental disabilities (DDs) ( = 1735), and general population-based controls (POPs) ( = 1578). We subdivided the ASD group according to whether children had ID and the DD group according to whether they had ID and/or some ASD characteristics. Standardized developmental assessments and/or questionnaires were used to define final study groups, subgroups, and pica. We examined pica prevalence in each group and compared ASD and DD groups and subgroups to the POP group using prevalence ratios adjusted for sociodemographic factors.
RESULTS
Compared with the prevalence of pica among POPs (3.5%), pica was higher in children with ASD (23.2%) and DD (8.4%), and in the following subgroups: ASD with ID (28.1%), ASD without ID (14.0%), DD with ID (9.7%), DD with ASD characteristics (12.0%), and DD with both ID and ASD characteristics (26.3%); however, pica prevalence was not elevated in children with DD with neither ID nor ASD characteristics (3.2%). Between-group differences remained after adjustment (adjusted prevalence ratio range 1.9-8.0, all <.05).
CONCLUSIONS
Pica may be common in young children with ASD, ASD characteristics, and ID. These findings inform the specialized health care needs of these children.
Topics: Adult; Autism Spectrum Disorder; Case-Control Studies; Child, Preschool; Developmental Disabilities; Female; Humans; Intellectual Disability; Male; Pica; Young Adult
PubMed: 33408069
DOI: 10.1542/peds.2020-0462 -
Journal of Clinical Psychology in... Mar 2021Pica is the developmentally inappropriate consumption of non-nutritive items for at least one month. Pica can lead to many adverse outcomes, but the exact... (Review)
Review
Pica is the developmentally inappropriate consumption of non-nutritive items for at least one month. Pica can lead to many adverse outcomes, but the exact pathophysiology of pica is unknown or variable across populations. Several studies have evidenced that there is a high prevalence of pica among youth with sickle cell disease (SCD). However, the lack of knowledge regarding the correlates of pica contributes to overlooking the condition, inaccurate diagnoses, and a lack of evidence-based treatments once pica is identified. This review examines the literature to develop a biopsychosocial model of pica in SCD. Elucidating the potential relationships among the proposed biological, psychological, and social factors, and pica will inform our understanding of this phenomenon in pediatric SCD and may guide future research and clinical recommendations.
Topics: Adolescent; Anemia, Sickle Cell; Child; Humans; Pica; Prevalence
PubMed: 31659594
DOI: 10.1007/s10880-019-09671-x -
Nursing Jul 2023
Topics: Humans; Pica
PubMed: 37343253
DOI: 10.1097/01.NURSE.0000936780.65756.90 -
Industrial Psychiatry Journal Oct 2021Geophagia, a form of pica, is often associated with iron and zinc deficiency. However, a number of environmental, cultural, and psychological factors are also...
Geophagia, a form of pica, is often associated with iron and zinc deficiency. However, a number of environmental, cultural, and psychological factors are also implicated. Pica in children is common with those having intellectual disability. In adults, it is most commonly associated with pregnancy. No specific screening tests for pica exist, but many nutritional and psychological complications can be avoided by accurate and timely diagnosis. Even when pica is diagnosed, no proven treatments exist. Two patients who reported to the psychiatry outpatient department with habit of eating nonnutritive substances for a prolonged period associated with apprehension and decreased appetite are reported. Both the patients were diagnosed with adult pica and were treated with selective serotonin-reuptake inhibitors and psychotherapy with considerable improvement.
PubMed: 34908699
DOI: 10.4103/0972-6748.328819 -
IBRO Neuroscience Reports Dec 2023Motions sickness (MS) occurs when the brain receives conflicting sensory signals from vestibular, visual and proprioceptive systems about a person's ongoing position...
Motions sickness (MS) occurs when the brain receives conflicting sensory signals from vestibular, visual and proprioceptive systems about a person's ongoing position and/or motion in relation to space. MS is typified by symptoms such as nausea and emesis and implicates complex physiological aspects of sensations and sensorimotor reflexes. Use of animal models has been integral to unraveling the physiological causality of MS. The commonly used rodents (rat and mouse), albeit lacking vomiting reflex, reliably display phenotypic behaviors of pica (eating of non-nutritive substance) and conditioned taste aversion (CTAver) or avoidance (CTAvoi) which utilize neural substrates with pathways that cause gastrointestinal malaise akin to nausea/emesis. As such, rodent pica and CTAver/CTAvoi have been widely used as proxies for nausea/emesis in studies dealing with neural mechanisms of nausea/emesis and MS, as well as for evaluating therapeutics. This review presents the rationale and experimental evidence that support the use of pica and CTAver/CTAvoi as indices for nausea and emesis. Key experimental steps and cautions required when using rodent MS models are also discussed. Finally, future directions are suggested for studying MS with rodent pica and CTAver/CTAvoi models.
PubMed: 38204574
DOI: 10.1016/j.ibneur.2023.06.006 -
Acta Neurochirurgica Dec 2023Posterior inferior cerebellar artery (PICA) aneurysms are uncommon, and their management is challenging because of the complex angioarchitecture of the PICA and the...
BACKGROUND
Posterior inferior cerebellar artery (PICA) aneurysms are uncommon, and their management is challenging because of the complex angioarchitecture of the PICA and the frequently nonsaccular aneurysm presentation. Endovascular therapy may not be feasible.
METHODS
We describe our technique of clip trapping with occipital artery (OA)-to-PICA bypass to treat a PICA aneurysm. Because the aneurysm affected the ipsilateral, dominant PICA, an OA-PICA bypass was chosen to ensure adequate flow and reduce risk to the contralateral PICA supply.
CONCLUSION
The OA-PICA anastomosis is a safe and effective method to successfully achieve flow preservation with bypass reconstruction and aneurysm trapping.
Topics: Humans; Cerebral Revascularization; Cerebellum; Vertebral Artery; Vertebral Artery Dissection; Intracranial Aneurysm
PubMed: 37256439
DOI: 10.1007/s00701-023-05633-3