Eating Disorders: Pica - Eating Disorders, Pica Causes

Written by HealthyPlace.com Staff Writer

Causes:

Although the etiology of pica is unknown, numerous hypotheses have been advanced to explain the phenomenon, ranging from psychosocial causes to causes of purely biochemical origin. Cultural, socioeconomic, organic, and psychodynamic factors have been implicated.

• Nutritional deficiencies:
  • Although firm empirical data supporting any of the nutritional deficiency etiologic hypotheses are absent, deficiencies in iron, calcium, zinc, and other nutrients (eg, thiamine, niacin, vitamins C and D) have been associated with pica.
  • In some patients with malnutrition who eat clay, iron deficiencies have been diagnosed, but the direction of this causal association is unclear. Whether the iron deficiency prompted the eating of clay or the inhibition of iron absorption caused by the ingestion of clay produced the iron deficiency is not known.
• Cultural and familial factors
  • In particular, the ingestion of clay or soil may be culturally based and is regarded as acceptable by various social groups.
  • Parents may proactively teach their children to eat these and other substances.
  • Pica behavior also may be learned via modeling and reinforcement.
• Stress: Maternal deprivation, parental separation, parental neglect, child abuse, and insufficient amounts of parent/child interactions have been associated with pica.
• Low socioeconomic status
  • The ingestion of paint is most common in children from low socioeconomic families and is associated with lack of parental supervision.
  • Malnutrition and hunger also may result in pica.
• Nondiscriminating oral behavior: In individuals with mental retardation, pica has been suggested to result from an inability to discriminate between food and nonfood items; however, this theory is not supported by findings of selection of pica items and the often aggressive search for nonfood items of choice.
• Learned behavior: In individuals with mental retardation and developmental disabilities in particular, the traditional view is that the occurrence of pica is a learned behavior maintained by the consequences of that behavior.
• Underlying biochemical disorder: The association of pica, iron deficiency, and a number of pathophysiologic states with decreased activity of the dopamine system has raised the possibility of a correlation between diminished dopaminergic neurotransmission and the expression and maintenance of pica; however, specific pathogenesis resulting from any underlying biochemical disorders has not been identified empirically.
• Other risk factors
• Parent/child psychopathology
• Family disorganization
• Environmental deprivation
• Pregnancy
• Epilepsy
• Brain damage
• Mental retardation
• Developmental disorders

TREATMENT

Medical Care:

• Although pica in children often remits spontaneously, a multidisciplinary approach involving psychologists, social workers, and physicians is recommended for effective treatment.
• Development of the treatment plan must take into account the symptoms of pica and contributory factors, as well as the management of possible complications of the disorder.
• No medical treatment is specific in the treatment of patients with pica.