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Expert Review of Hematology Nov 2016Pica is the compulsive eating of non-nutritive substances. It is often associated with iron deficiency but its pathophysiology is unknown. Areas covered: We searched the... (Review)
Review
Pica is the compulsive eating of non-nutritive substances. It is often associated with iron deficiency but its pathophysiology is unknown. Areas covered: We searched the literature using the keywords listed below. Our aim was to describe the phenomenon in its various aspects, to touch briefly on the historical and cultural background, and to examine in more detail the studies that tried to analyze the relative roles of iron deficiency and pica. Expert commentary: Pica is an intriguing symptom known for centuries. Pregnant women and preadolescents are at the highest risk of pica. Iron absorption is reduced in the presence of non-nutritive substances. Iron therapy usually cures the pica behavior. There are different forms of pica, one caused directly by iron deficiency probably due to the lack of iron in some areas of the brain and one more culturally driven and including mostly geophagy.
Topics: Anemia, Iron-Deficiency; Female; Humans; Mental Disorders; Nervous System Diseases; Phenotype; Pica; Pregnancy; Pregnancy Complications, Hematologic; Prevalence; Risk Factors
PubMed: 27701928
DOI: 10.1080/17474086.2016.1245136 -
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 -
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 -
Journal of Medical Imaging and... Oct 2018
Review
Topics: Humans; Pica; Stomach; Tomography, X-Ray Computed
PubMed: 30309086
DOI: 10.1111/1754-9485.43_12784 -
Journal of the Royal Society of Health Oct 1997Pica is the compulsive eating of non-food substances over a sustained period of time. It remains an intriguing, little understood occurrence, with a potential for both... (Review)
Review
Pica is the compulsive eating of non-food substances over a sustained period of time. It remains an intriguing, little understood occurrence, with a potential for both positive and negative outcomes. In this review information is given on the history of the phenomenon, its prevalence among children and women, and its relation to iron and zinc deficiency. A number of examples of pica practice are reported from Africa.
Topics: Adolescent; Adult; Africa; Child; Child, Preschool; Deficiency Diseases; Female; Humans; Infant; Iron Deficiencies; Male; Pica; Pregnancy; Prevalence; Zinc
PubMed: 9519658
DOI: 10.1177/146642409711700503 -
Nefrologia 2019Pica is an individual entity in the patient with chronic kidney disease (CKD), which phenomenon has not been widely studied despite the high reported prevalence.... (Review)
Review
Pica is an individual entity in the patient with chronic kidney disease (CKD), which phenomenon has not been widely studied despite the high reported prevalence. Moreover, pica complications (anemia, altered electrolytes, poor absorption of micro and macronutrients and malnutrition) could be exacerbated in CKD and limit the quality of renal replacement therapy. The intake of non-caloric and non-nutritional substances could be harmful and cause effects on satiety and metabolic / electrolyte imbalance and modify the biocompatibility of micronutrients, toxins and pathogens worsening health status. In daily practice, pica could be under-reported because patient's shame to recognize it, or fear that such behavior influences their treatment. Additionally, clinicians who not investigate the presence of pica or its complications contribute to the lack of information about the magnitude and relevance of this problem in CKD.
Topics: Anemia; Child; Female; Humans; Kidney Failure, Chronic; Micronutrients; Nutrition Disorders; Pica; Poisoning; Pregnancy; Pregnancy Complications
PubMed: 30360922
DOI: 10.1016/j.nefro.2018.08.001 -
Current Pediatric Reviews 2019Pica is a common condition in childhood that is commonly missed. (Review)
Review
BACKGROUND
Pica is a common condition in childhood that is commonly missed.
OBJECTIVE
To familiarize physicians with the clinical evaluation and management of children with pica.
METHODS
A PubMed search was completed in Clinical Queries using the key term "pica" OR "dirteating". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Only papers published in English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.
RESULTS
Pica refers to the persistent, compulsive craving for and the ingestion of substances usually considered inedible and the behavior is discordant with cultural practices and continues beyond the normal developmental phase of occasional indiscriminate and experimental mouthing and swallowing over a period of at least one month. The condition is more common among children in lower socioeconomic classes and those who are mentally handicapped or emotionally deprived. Pica is a significant cause of anemia and lead poisoning. Pica generally resolves in children of normal intelligence after they have been trained to discriminate between edible and inedible items and proper supervision is provided. While relief of family economic and housing difficulties is an adjunct, attention to the individual's emotional needs and stresses is of paramount importance. Children with iron deficiency anemia should be treated with iron replacement therapy. Complications such as gastrointestinal obstruction and lead poisoning should be promptly recognized and treated.
CONCLUSION
Pica is often an overlooked phenomenon and its association with iron deficiency and lead poisoning has been known for centuries. The underlying cause and complications should be treated if possible. Primary care physicians should be aware of pica and proactively seek information about pica in patients that belong to the high-risk groups.
Topics: Anemia, Iron-Deficiency; Animals; Child; Disease Management; Global Health; Humans; Intellectual Disability; Lead Poisoning; Malnutrition; Morbidity; Pica; Risk Assessment; Risk Factors
PubMed: 30868957
DOI: 10.2174/1573396315666190313163530 -
Social Work in Public Health Jun 2020Pica is simply defined as the consumption of none food products such as laundry starch, clay dirt, ice, soap, and chalk. The Diagnostic and Statistical Manual of Mental... (Review)
Review
Pica is simply defined as the consumption of none food products such as laundry starch, clay dirt, ice, soap, and chalk. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies Pica as the habitual consumption of nonfood and non-nutritive substances for at least one year. Pica disorder is usually unnoticed, under-reported, causes serious harm to clients especially African American women, and seldom discussed in social work scholarship. It is, therefore, important to begin to sensitize social workers to the harmful effects of Pica, especially because it is often unrecognized and misdiagnoses can cause harm. This article provides a panoramic overview of Pica, the signs and symptoms of the disorder specifically among African American women and also address some of the adverse effects, and highlights some of the evidence-based effective treatment strategies. Finally, an urgent clarion call to social workers to conduct more research on Pica disorders among African American women is articulated.
Topics: Black or African American; Female; Humans; Pica
PubMed: 32660362
DOI: 10.1080/19371918.2020.1791778 -
Annual Review of Nutrition 1982
Review
Topics: Adolescent; Adult; Age Factors; Aged; Behavior Therapy; Child; Deficiency Diseases; Dietary Proteins; Disease Susceptibility; Feeding Behavior; Female; Health Status; Humans; Iron; Male; Middle Aged; Pica; Pregnancy; Self Medication
PubMed: 6764733
DOI: 10.1146/annurev.nu.02.070182.001511 -
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