Pica disease is an eating disorder characterized by repeated ingestion of inedible and non-nutritious substances for at least one month. What are the substances most often ingested? What are the causes of this disease? How to treat it? We take stock of this often unrecognized disorder with Dr. Stéphane Clerget, the psychiatrist.
Pica: is it really an eating disorder?
Pica is part of eating disorders, just like anorexia or bulimia. A classification that raises the question, according to Dr. Clerget, “ I do not consider pica as an eating disorder because what patients put in their mouth is not associated with food. Can we speak of an eating disorder to the extent that the person does not consider what they ingest as food? “.This disease affects children as well as adults. But be careful; we speak of Pica syndrome when the person is over two years old because, before this age, children do not yet know how to distinguish what is edible and what is not. “The little ones taste everything and swallow things without it being considered a behavioral disorder. It is not pathological,” insists the psychiatrist.
Pica disease: what are the substances ingested?
Patients most often ingest earth (geophagy), dust, pebbles, chalk. They consume them regularly, in addition to their usual diet. Trichophagia, which involves eating your hair after pulling it out, can also be associated with Pica. “ In my practice, I often meet adolescents or young adults suffering from trichophagia, a disease that I include in the context of Pica because the hair is not edible,” says the specialist.
When Pica is a psychotic disorder or dementia symptom, there may be coprophagia (ingestion of feces). “ It is observed in people who have major personality disorders.
Causes of Pica’s disease
One in two patients has psychotic disorders or developmental delays such as “ pervasive developmental disorder (PDD), autism spectrum disorder (ASD) or reality disorder such as schizophrenia.” In these cases, Pica is only a symptom of more serious mental disorders.
This syndrome can also affect people who are not psychotic. “ These are often adolescents who suffer from disturbances of self-image, of their own body. So they ingest inedible things to ease anxiety, fill a void, feel less fragile, “ explains Dr. Clerget.
Finally, Pica can be a sign of an affective disorder. “I had this case of a 4-year-old child who swallowed his mother’s cigarette butts. A mother absent from an emotional point of view and who smoked cigarette after cigarette, The child, not psychotic, wanted to attract his mother’s attention by eating her cigarettes because he saw that she was very attached to tobacco; it was his way of getting closer to her. In this specific case, Pica’s disease was a symptom. Of a disorder of the child’s attachment to his mother, “ says the psychiatrist.
How to treat Pica disease?
In half of the cases, Pica is symptomatic of a psychiatric illness. “ We treat the psychological disease as a whole by psychotherapy. There is no drug treatment, but we take care of the medical complications if there are any. “ Indeed, patients expose themselves to risks to their health. These will depend on the toxicity and the dangerousness of the elements ingested. For example, suppose the ingested objects are sharp, unbreakable ( coins ), or very compact. In that case, there is a risk of perforation of the digestive tract or intestinal obstruction (blockage of digestive transit in one of the two intestines). Sick people can also suffer from undernutrition or deficiencies.
“Better to go see a general practitioner in the first intention so as not to endanger the vital prognosis after having ingested toxic or sharp things. Then a psychiatrist, if the disease originates from a psychiatric disorder of which Pica is only one symptom, “ advises the specialist.