Iron or zinc deficiencyUNKNOWN alters appetite-regulating brain enzymes that may trigger specific cravings Dieting- people who

diet may attempt to ease hunger by eating nonfood substances to get a feeling of fullness Malnutrition- especially in underdeveloped countries, where people with pica most commonly eat soil or clay Cultural factors- in families, religions, or groups in which eating nonfood substances is a learned practice Parental neglect, lack of supervision, or food deprivation- often seen in children living in poverty Developmental problemssuch as mental retardation autism, other developmental disabilities, or brain abnormalities Psychiatric disorders- such as psychosis, depression, anxiety disorder, mania, delirium Pregnancy- frequently in women who exhibited similar practices during their childhood or before pregnancy or who have a history of pica in their family

"Pica"- Latin word for magpie, a bird which is reputed to eat almost anything Persistent ingestion of nonnutritive substances, craving or eating of items that SSRIs are antidepressants in are not food the treatment of depression, Examples: paint, hair, cloth, leaves, sand, coal, clay, feces, chalk, paper, soap, anxiety disorders, and some glue, rocks or soil personality disorders have Abnormal appetite for some things that may be considered foods such as food been used successfully to ingredients treat pica. Examples: flour, raw potato, raw rice, starch, ice cubes, salt, coffee grinds, baking soda P DON VAD Normal in infants and toddlers up to 2 years old, because of innocent Physical restraint: Forms Nonnutritive exploration self-protection devices that

Amylophagia Coprophagia Geophagia

Hyalophagia Mucophagia Pagophagia Selfcannibalism Trichophagia hair or wool Urophagia urine Xylophagia criteria for PICA: all three are wood DSM IV TR present Repetitive consumption of nonfood items, despite efforts to restrict it, for a period of at least 1 month or longer The behavior is considered inappropriate for age or developmental stage (older than 24 months) The behavior is not part of a cultural, ethnic, or religious practice

Substance Consumed starch feces mud, soil, clay, or chalk glass mucus ice body parts

Malnutrition Intestinal obstruction Intestinal infections and Parasitic Infestation Anemia Mercury poisoning Liver and Kidney damage Constipation and abdominal problems Lead poisoning Tearing in the stomach

Prepared by: Mari Ann J. San Juan BSN III- Nightingale

prohibit placement of objects in the mouth brief restraint contingent on pica being attempted Differential reinforcementpositive reinforcement if pica is not attempted and negative reinforcement if pica is attempted Overcorrection- attempted pica resulting in required washing of self, disposal of nonedible objects, and chore-based punishment Negative practice- nonedible object held against patient's mouth without allowing ingestion Visual screening- briefly for a short time after pica is attempted Aversive presentationcontingent on pica being attempted: oral taste (e.g., lemon) smell sensation (e.g., ammonia) physical sensation (e.g., water mist in face) Discrimination training between edible and inedible items