Pica Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Pica is a form of eating disorder, in which the affected person consumes ingredients that have little or no nutritional value. This pattern continues continuously for at least one month. In addition, this eating disorder also generally occurs at an age when these actions are no longer in accordance with the level of development of the person’s age.
People with pica often eat ingredients that aren’t actually food. The amount consumed is usually large and sufferers generally do not pay attention to the nutritional value that their body needs. Examples of materials often consumed by Pica sufferers include paper, soap, cloth, hair, thread, soil, chalk, powder, paint, gravel, charcoal, ashes, clay, starch/starch, ice cubes, and so on.
Symptom
Pica behavior according to DSM-5 criteria is a symptom related to the patient’s eating pattern. Various complaints can also arise due to the consumption of non-food ingredients, such as:
• poisoning due to consumption of toxic substances (eg lead poisoning)
• presence of symptoms of infection, especially parasites (eg worms)
• digestive tract complaints (constipation, intestinal obstruction, perforation, ulceration, etc.)
• dental complaints (eg tooth abrasion)
Reason
The exact cause of Pica’s behavior is not known until now. However, there are several theories that try to explain why someone does Pica, namely:
• Presence of anemia due to iron deficiency and malnutrition.
Pica is associated with deficiencies of iron, calcium, zinc, and other substances (such as thiamine, niacin, and vitamins C and D). It is estimated, the body of someone who is experiencing malnutrition tries to find a substitute for the lacking substance, one of which is by consuming certain ingredients.
• A person with mental health problems and experiencing limitations in carrying out daily life functions. For example: mental disability, autism, schizophrenia, and so on.
• Cultural factors, social norms and family. For example: some cultures have a tradition of consuming earth and clay.
• Stress.
• Low socio-economic class.
Diagnosis
Gathering information from sufferers is usually sufficient to determine the diagnosis of pica. Oftentimes, Pica perpetrators are embarrassed to admit what they have done. Questions that are not judgmental will be more helpful for sufferers to admit their behavior. For example, by asking him to explain about eating patterns, types of food eaten as snacks, a strong desire to eat certain ingredients or types of food, something that must be eaten, and so on.
Based on The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the following are some of the Pica criteria:
• The behavior of consuming materials that have no nutrition and are not food ingredients on an ongoing basis and is carried out for a period of at least one month.
• Eating behavior that is not in accordance with the developmental stage of the individual’s age. Children under the age of two often put various objects in their mouths. This action is a normal part of the development of children who are trying to explore the various sensory systems. Therefore, children under two years cannot be called sufferers of pica.
But it is different if the behavior is carried out by older children or adults.
• Consumption behavior of certain materials that are not in accordance with local customs, social norms or culture.
• If this behavior occurs in conjunction with certain medical conditions or mental problems (eg autism, schizophrenia, or pregnancy), then more severe conditions require attention and separate clinical examination.
Treatment
Pica is often found in people with iron deficiency and is even found in nearly 50 percent of people with iron deficiency. Often, in these malnourished individuals, the Pica’s behavior will improve once the malnutrition is resolved.
Therefore, it is important to know if the patient has a deficiency of certain nutrients. Furthermore, providing appropriate supplementation can be an effective way of treatment.
The Pica offender may also need psycho-social intervention. In this case, consultation with a psychologist or psychiatrist may be necessary. Also applicable are the exercises of distinguishing between edible and inedible substances, controlling impulses to eat non-food substances, and similar exercises. Because of this, there is no specific pharmacological therapy (drugs) to cure pica.
Prevention
For some cases due to mental disorders, Pica cannot simply be prevented. This problem can arise at any time as there is a condition of disturbance in the sufferer’s nervous system. But for several other cases, fulfilling good nutrition from infancy to childhood can reduce the risk of pica.