Definition and Diagnosis

Abstract

Pica refers to the problematic consumption of non-nutritive substances. It can be distinguished from developmentally typical mouthing, problematic mouthing of objects, and hand mouthing because it involves consumption rather than mouthing of non-nutritive substances. Pica should be diagnosed accurately and promptly to ensure access to treatment. Different forms of pica have been recognized for hundreds of years. These include culture-specific practices, such as ritualistic eating of dirt. Pica is also observed in pregnancy and biomedical disorders, such as anemia and sickle cell disease, cases of lead poisoning, and nutritional deficiencies, such as iron and zinc deficiency. It is most commonly recognized as problematic in individuals with developmental and psychiatric disorders. Pica is most commonly highly problematic in individuals with severe and profound intellectual disabilities (ID). Pica is also observed in animals, especially those with nutritional deficiencies. The risks of pica vary from mild and transient to life-threatening and fatal.