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异食癖 - 精神健康障碍 - 《默沙东诊疗手册大众版》

默沙东诊疗手册

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进食障碍概述

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异食癖

作者：

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, MD, Columbia University Medical Center;

B. Timothy Walsh

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全面审查/修订7月 2022 | 修改的 9月 2022

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异食癖是一种进食障碍进食障碍概述进食障碍是指进食或进食相关行为的紊乱，通常涉及进食种类或进食量的改变采取措施防止食物的吸收（例如自我催吐或服用泻药）异常进食行为在达到以下标准时可视为进食障碍：持续一定时间且严重损害患者的身体健康和／或工作学习，或对患者的人际交往产生不良影响。... 阅读更多，特征是经常吃一些非食物的东西。通常，异食癖患者吃的东西不会对他们造成伤害，但有时他们进食的东西会引起并发症，如消化道梗阻或铅中毒。当年龄超过 2 岁的人进食非食物的东西达一个月或以上时，医生通常会诊断异食癖。行为矫正疗法可能有帮助，但目前尚无专门针对异食癖的治疗方法。营养不良和其他并发症可按需治疗。异食癖者经常吃一些不能吃的东西（如纸、陶土、泥土或头发）。此行为如果发生在 2 岁以下儿童，则视为正常发育现象。年幼儿童经常将各种东西放入口中，有时会吃他们。异食癖也可能发生在妊娠期。在世界某些地区，进食不属于食物的东西是传统文化（如民间医药、宗教仪式或惯常做法等）的一部分。例如，佐治亚州皮德蒙特地区的有些人定期吃陶土。通常而言，异食癖者所吃的东西不会对其造成伤害。通常而言，异食癖者所吃的东西不会对其造成伤害。但是，他们吃的东西有时会导致并发症，如便秘成人便秘便秘是排便次数减少或排便困难，大便坚硬或大便后直肠有未排净感（不完全排净）。（也可参见儿童便秘。）便秘有急性和慢性。急性便秘往往出现的很明显且突然。慢性便秘常缓慢出现，有时持续数月或数年。很多人认为如果一天不排便，就是便秘。然而，不是每个人每天都会有排便的。每天1至3次排便到每周2至3次排便都属正常现象。排便减少并不一定表明就是存在便秘，除非和以前的排便习惯相比，近期发生了显著的变化。如果大便的颜色和性状没有太显著的变化，人们通常... 阅读更多、消化道梗阻肠梗阻肠梗阻是指肠道完全阻塞或严重阻碍食物、液体、消化道分泌物和气体通过肠道。成人患者的最常见病因是既往腹部手术后形成的瘢痕组织、疝和肿瘤。常见症状是疼痛、腹胀和食欲不振。体格检查和X线检查可诊断。常需手术解除梗阻。阅读更多、由吃油漆屑导致的铅中毒铅中毒铅中毒影响身体的很多部位，包括大脑、神经、肾、肝和血液。儿童对铅特别敏感，因为他们的神经系统仍在发育。铅中毒的一些原因包括摄入了含铅油漆，使用某些进口、不当处理的铅釉陶瓷饮食而摄入铅。血中铅水平非常高可能引起性格改变、头痛、丧失知觉、乏力、口腔内金属味、行走不协调、消化系疾病和贫血。根据症状和血液检查得出诊断。检测家用用水、陶瓷和涂料的铅含量可有助于识别潜在的铅中毒来源。阅读更多，以及吃土导致的寄生虫感染寄生虫感染概述寄生虫是一种生活在另一种生物（宿主）表面或内部，并从宿主那里受益（例如，通过获取营养）的生物。虽然这一定义实际上适用于许多微生物，包括细菌、真菌和病毒，但术语“寄生虫”用来指仅由一个细胞构成的原虫（如阿米巴）由更大的及多个细胞构成并拥有内部脏器的蠕虫（肠虫）... 阅读更多。异食癖本身很少影响社会功能，但它常常合并其他精神疾病，这些障碍可影响社会功能。这些障碍包括孤独症自闭症谱系障碍孤独症谱系障碍是指人们难以发展正常社交关系，使用语言异常或根本不使用语言，并表现出受限或重复行为。患者很难与他人沟通和建立关系。孤独症谱系障碍患者的行为、兴趣和/或活动模式也受限制，并且经常遵循严格的常规模式。诊断基于观察、父母和其他照护者的报告以及标准化孤独症特异性筛查测试。大多数人对高度组织化的行为干预反应最佳。阅读更多、智障智力障碍智力障碍是指出生时或婴儿早期智力功能远远低于平均水平，从而限制正常日常生活活动的能力。智力障碍可能是遗传性，也可能是干扰大脑发育的疾病导致的结果。大多数智力障碍儿童直到上学才出现明显的症状。诊断基于正式测试的结果。适当的产前护理可以降低生下智力障碍儿童的风险。阅读更多和精神分裂症精神分裂症精神分裂症是一种以脱离现实（精神错乱）、各种幻觉（通常为幻听）、坚定的虚假信念（妄想）、异常思维和行为、情感表达减少、动机消失以及日常功能（包括工作、社交和自理能力）受损为特征的精神疾病。精神分裂症的病因和机制均不清楚。本病患者症状多样，包括行为怪异、言语瓦解、情感平淡、寡言少语、无法集中注意力或进行回忆。医生在做检查排除其他可能的精神病因之后，根据症状作出精神分裂症的诊断。... 阅读更多异食癖的诊断医师的评估各项辅助检查，以排查可能的并发症通常，医生通过判定患者在吃什么东西来诊断异食癖。患者持续吃一些不属于食物的东西，持续 1 个月或更长时间，即可诊断为异食癖。两岁以下的儿童出现这种行为不诊断为异食癖，因为在那个年龄时，吃这些东西不会被认为是异常的。如果异食行为是文化的一部分，也不诊断为异食癖。如果医生怀疑本病，他们会评估患者的营养状况营养状况评估营养是消化、吸收和利用营养素的过程，这些营养素是人体生长、发育以及维持生命所必需的。为了得到足够以及合适的营养，人体需要进食健康的食物，这些食物由各种不同的营养素（食物中能够营养人体的物质）组成。健康的饮食能使人们保持理想的体重和身体成分（体内脂肪与肌肉的百分比），维持日常体力和脑力活动，并最大限... 阅读更多，确认是否存在体重减轻和营养不良。有些时候，异食癖是在儿童出现消化道梗阻症状（比如重度痉挛或便秘）或铅中毒并被带到急诊科或门诊就诊时确诊的。要确认消化道梗阻，可能需要做 X 线检查。医生可能会做血液检查，以检查铅中毒或寄生虫感染。异食癖的治疗有时需采取行为矫正治疗治疗营养不良和其他并发症行为矫正疗法可能有帮助，但目前尚无专门针对本病的治疗方法行为矫正疗法可帮助人们消除不理想的行为，同时学习更好的行为。对营养不良和其他并发症进行治疗。消化道梗阻可能需要手术。异食癖可在持续数月后自行消失，特别是在儿童中。了解更多信息以下是一些可能有帮助的英文资料。请注意，本手册对该资料中的内容不承担责任。美国进食障碍帮助协会 (NEDA)：大型非营利组织，提供在线筛选工具、帮助热线、论坛和各种支持团体（部分为虚拟团体）美国国家神经性厌食症和相关疾病协会 (ANAD)：为医疗卫生专业人士提供课程和培训，并为饮食障碍患者及其家人提供同伴支持团体、自我帮助和其他服务

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MIT

pica - high quality image resize in browser

Resize images in browser without pixelation and reasonably fast.

Autoselect the best of available technologies: webworkers,

webassembly, createImageBitmap, pure JS.

demo

With pica you can:

Reduce upload size for large images, saving upload time.

Saves server resources on image processing.

Generate thumbnails in browser.

...

Note. If you need File/Blob resize (from form's file input), consider use

image-blob-reduce. It has

additional machinery to process orientation, keep EXIF metadata and so on.

Migration from pica v6 to pica v7

Multiply unsharpAmount by 2, divide unsharpThreshold by 2, example:

pica@6: pica.resize(a, b, { unsharpAmount: 80, unsharpThreshold: 2 })

pica@7: pica.resize(a, b, { unsharpAmount: 160, unsharpThreshold: 1 })

Prior to use

Here is a short list of problems you can face:

Loading image:

Due to JS security restrictions, you can process images

from the same domain or local files only. If you load images from

remote domain use proper Access-Control-Allow-Origin header.

iOS has a memory limits for canvas elements, that may cause

problems in some cases, more details.

If your source data is jpeg image, it can be rotated. Consider use

image-blob-reduce.

Saving image:

Some ancient browsers do not support canvas.toBlob() method.

Use pica.toBlob(), it includes required shim.

For jpeg source, it's a good idea to keep exif data. Consider use

image-blob-reduce.

Quality

JS canvas does not support access to info about gamma correction.

Bitmaps have 8 bits per channel. That causes some quality loss,

because with gamma correction precision could be 12 bits per

channel.

Precision loss will not be noticeable for ordinary images like

kittens, selfies and so on. But we don't recommend this library

for resizing professional quality images.

Install

npm install pica

Use

const pica = require('pica')();

// Resize from Canvas/Image to another Canvas

pica.resize(from, to)

.then(result => console.log('resize done!'));

// Resize & convert to blob

pica.resize(from, to)

.then(result => pica.toBlob(result, 'image/jpeg', 0.90))

.then(blob => console.log('resized to canvas & created blob!'));

API

new Pica(config)

Create resizer instance with given config (optional):

tile - tile width/height. Images are processed by regions,

to restrict peak memory use. Default 1024.

features - list of features to use. Default is

[ 'js', 'wasm', 'ww' ]. Can be [ 'js', 'wasm', 'cib', 'ww' ]

or [ 'all' ]. Note, cib is buggy in Chrome and not supports default

mks2013 filter.

idle - cache timeout, ms. Webworkers create is not fast.

This option allow reuse webworkers effectively. Default 2000.

concurrency - max webworkers pool size. Default is autodetected

CPU count, but not more than 4.

createCanvas - function which returns a new canvas, used internally

by pica.

Default returns a

but this function could return an OffscreenCanvas

instead (to run pica in a Service Worker). Function signature: createCanvas(width: number, height: number): Canvas

Important! Latest browsers may support resize via createImageBitmap.

This feature is supported (cib) but disabled by default and not recommended

for use. So:

createImageBitmap() is used for non-blocking image decode (when available,

without downscale).

It's resize feature is blocked by default pica config. Enable it only on your

own risk. Result with enabled cib will depend on your browser. Result

without cib will be predictable and good.

.resize(from, to, options) -> Promise

Resize image from one canvas (or image) to another. Sizes are

taken from source and destination objects.

from - source, can be Canvas, Image or ImageBitmap.

to - destination canvas, its size is supposed to be non-zero.

options - quality (number) or object:

quality (deprecated, use .filter instead) - 0..3.

filter - filter name (Default - mks2013). See resize_filter_info.js for details. mks2013 does both resize and sharpening, it's optimal and not recommended to change.

unsharpAmount - >=0. Default = 0 (off). Usually

value between 100 to 200 is good. Note, mks2013 filter already does

optimal sharpening.

unsharpRadius - 0.5..2.0. By default it's not set. Radius of Gaussian

blur. If it is less than 0.5, Unsharp Mask is off. Big values are clamped

to 2.0.

unsharpThreshold - 0..255. Default = 0. Threshold for

applying unsharp mask.

cancelToken - Promise instance. If defined, current

operation will be terminated on rejection.

Result is Promise, resolved with to on success.

(!) If you need to process multiple images, do it

sequentially to optimize CPU & memory use. Pica already knows

how to use multiple cores (if browser allows).

.toBlob(canvas, mimeType [, quality]) -> Promise

Convenience method, similar to canvas.toBlob(), but with

promise interface & polyfill for old browsers.

.resizeBuffer(options) -> Promise

Supplementary method, not recommended for direct use. Resize

Uint8Array with raw RGBA bitmap (don't confuse with

jpeg / png / ... binaries). It does not use tiles & webworkers.

Left for special cases when you really need to process raw

binary data (for example, if you decode jpeg files "manually").

options:

src - Uint8Array with source data.

width - src image width.

height - src image height.

toWidth - output width, >=0, in pixels.

toHeight - output height, >=0, in pixels.

quality (deprecated, use .filter instead) - 0..3.

filter - filter name (Default - mks2013). See resize_filter_info.js for details. mks2013 does both resize and sharpening, it's optimal and not recommended to change.

unsharpAmount - >=0. Default = 0 (off). Usually

value between 100 to 200 is good. Note, mks2013 filter already does

optimal sharpening.

unsharpRadius - 0.5..2.0. Radius of Gaussian blur.

If it is less than 0.5, Unsharp Mask is off. Big values are

clamped to 2.0.

unsharpThreshold - 0..255. Default = 0. Threshold

for applying unsharp mask.

dest - Optional. Output buffer to write data,

if you don't wish pica to create new one.

Result is Promise, resolved with resized rgba buffer.

What is "quality"

Pica has presets to adjust speed/quality ratio.

Simply use quality option param:

0 - Box filter, window 0.5px

1 - Hamming filter, window 1.0px

2 - Lanczos filter, window 2.0px

3 - Lanczos filter, window 3.0px

In real world you will never need to change default (max)

quality. All this variations were implemented to better

understand resize math :)

Unsharp mask

After scale down image can look a bit blured. It's good idea to sharpen it

a bit. Pica has built-in "unsharp mask" filter (off by default).

Set unsharpAmount to positive number to activate the filter.

Filter's parameters are similar to ones from Photoshop.

We recommend to start with unsharpAmount = 160,

unsharpRadius = 0.6 and unsharpThreshold = 1.

There is a correspondence between UnsharpMask parameters

in popular graphics software.

Browser support

We didn't have time to test all possible combinations, but in general:

Top level API should work in all browsers,

supporting canvas

and typed arrays.

Webworkers,

WebAssembly and

createImageBitmap

are not required, but they will be used if available.

If you plan to use only pure math core,

then typed arrays support will be enough.

Note. Though you can run this package on node.js, browsers

are the main target platform. On server side we recommend to use

sharp.

References

You can find these links useful:

discussions on stackoverflow:

chromium skia sources:

image_operations.cc,

convolver.cc.

pica for enterprise

Available as part of the Tidelift Subscription.

The maintainers of pica and thousands of other packages are working with Tidelift to deliver commercial support and maintenance for the open source packages you use to build your applications. Save time, reduce risk, and improve code health, while paying the maintainers of the exact packages you use. Learn more.

(The MIT License)

Permission is hereby granted, free of charge, to any person obtaining a copy

of this software and associated documentation files (the "Software"), to deal

in the Software without restriction, including without limitation the rights

to use, copy, modify, merge, publish, distribute, sublicense, and/or sell

copies of the Software, and to permit persons to whom the Software is

furnished to do so, subject to the following conditions:

The above copyright notice and this permission notice shall be included in

all copies or substantial portions of the Software.

THE SOFTWARE IS PROVIDED "AS IS", WITHOUT WARRANTY OF ANY KIND, EXPRESS OR

IMPLIED, INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY,

FITNESS FOR A PARTICULAR PURPOSE AND NONINFRINGEMENT. IN NO EVENT SHALL THE

AUTHORS OR COPYRIGHT HOLDERS BE LIABLE FOR ANY CLAIM, DAMAGES OR OTHER

LIABILITY, WHETHER IN AN ACTION OF CONTRACT, TORT OR OTHERWISE, ARISING FROM,

OUT OF OR IN CONNECTION WITH THE SOFTWARE OR THE USE OR OTHER DEALINGS IN

THE SOFTWARE.

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Pica | 什么是异食癖？ - 知乎

Pica | 什么是异食癖？ - 知乎切换模式写文章登录/注册Pica | 什么是异食癖？通心粉家园心理科普由心而治，遇见更好的自己。异食癖是指反复食用不可食用的食物。这是一种进食障碍。它可能很严重，并可能危及生命。食用的物品差别很大，可能包括纸张、塑料、布、污垢、粘土、油漆、岩石、肥皂、烟头、头发和硬币等金属碎片。 Pica诊断根据《精神障碍诊断和统计手册》（DSM-5），pica的诊断需要四个标准：反复食用非食品物质至少持续一个月。食用非食物物质不适合个人的发育水平。（2岁以下的儿童不能诊断异食癖，因为在较年轻的年龄，咀嚼不同种类的物体被视为正常发育。）饮食行为不是社会文化的一部分。如果进食行为发生在另一种精神障碍（例如智力残疾、自闭症谱系障碍、精神分裂症）或医疗状况（包括怀孕）的情况下，其严重程度足以引起额外的临床注意。在之前版本的DSM中，异食癖属于“通常在婴儿期、儿童期或青春期首次诊断的疾病”在当前版本中，它被移至新的合并部分“喂养和饮食障碍”这种变化反映了异食癖可以发生在成年人和儿童身上。如果食用非营养物质来抑制神经性厌食症患者的食欲，则不会诊断为异食癖。一些患有回避/限制性食物摄入障碍（ARFID）的人，尤其是那些根据食物的感官选择饮食的人，也可能患有异食癖。这些个体对质地非常敏感，可能会寻找具有首选质地的非营养物质。在吞食异物的情况下，非自杀性自残也会发生异食癖。虽然异食癖可以在任何年龄发生，但最常见的是在儿童时期。异食癖在孕妇和发育和智力残疾儿童中更为常见。它通常与其他疾病一起发生，如自闭症谱系障碍、强迫症和注意力缺陷/多动障碍。关于异食癖的研究有限。据信，这在美国健康儿童中很少见。12岁以上的美国儿童中，只有不到10%符合异食癖的诊断标准。一项研究报告称，镰状细胞贫血治疗儿童中异食癖患病率较高，另一项研究表明，非洲学龄儿童中异食癖患病率较高。在一些非洲国家，吃泥土的习俗在文化上是受认可的，并且可能在非裔美国人中继续作为一种基于其传统的文化规范做法。数据显示，异食癖在怀孕的非洲和非裔美国女性中更为普遍。非裔美国女性吃泥土可能被视为一种文化习俗。这可能是一种后天习得的行为，对社会和心理都有好处。当异食癖行为是一种文化支持的行为时，它不会被诊断为精神障碍。理论原因由于对异食癖的研究极其有限，对其危险因素的了解还不够。一种流行的理论是，矿物质缺乏，尤其是缺铁，会导致异食癖。许多证据来自病例报告，这些报告显示，在补充足够的物质含量后，行为停止了。有人提出，异食癖可能是在饮食不足的基础上，对压力作出反应而发展起来的。医疗风险异食癖可能与重大医疗风险有关，具体取决于摄入的物质和行为的严重程度。铅、汞（来自纸张）、锌和铜等重金属可能有毒。异食癖会导致胃和胃肠道大量消耗物质，肠阻塞，以及需要手术的眼泪。异食癖还会导致体内寄生虫、中毒、窒息、呼吸道问题和死亡等问题。治疗方法对于异食癖尚无公认的治疗方法。目前针对异食癖的干预措施包括手术以及营养、药理和行为治疗。当摄入的物品对身体造成损害时，可能需要进行手术干预，但不能解决潜在症状。关于异食癖行为干预的研究有限。现阶段最有可能成功治疗儿童异食癖的干预措施是联合治疗，包括强化程序，如偶然强化和歧视训练。对于患有异食癖的成年人来说，认知行为疗法（CBT）可能是一种有用的技术。这种治疗可能侧重于帮助患者改变他们对吃非食品的想法，改变行为，并用另一种应对策略来代替。发布于 2022-06-21 20:05异食癖心理健康赞同添加评论分享喜欢收藏申请

Pica: What It Is, Causes, Symptoms & Treatment

: What It Is, Causes, Symptoms & Treatment800.223.2273100 Years of Cleveland ClinicMyChartNeed Help?GivingCareersSearchClevelandClinic.orgFind A DoctorLocations & DirectionsPatients & VisitorsHealth LibraryInstitutes & DepartmentsAppointmentsHome/Health Library/Diseases & Conditions/PicaAdvertisementAdvertisementAdvertisementPicaPica is a mental health condition where a person compulsively swallows non-food items. It’s especially common in children and with certain conditions. While it’s often harmless, swallowing certain items can make pica very hazardous. Fortunately, it’s often treatable with therapy and modification to lifestyle and circumstances.ContentsArrow DownOverviewSymptoms and CausesDiagnosis and TestsManagement and TreatmentPreventionOutlook / PrognosisLiving WithContentsArrow DownOverviewSymptoms and CausesDiagnosis and TestsManagement and TreatmentPreventionOutlook / PrognosisLiving WithOverviewWhat is pica?Pica is an eating disorder where a person compulsively eats things that aren’t food and don’t have any nutritional value or purpose. Depending on when and why a person does this, pica can be normal, expected and harmless. However, it can cause major problems if a person with this condition eats something toxic or dangerous.Pronounced “PIKE-ah,” pica gets its name from a bird species, the Eurasian magpie (the formal Latin name for that species is Pica pica). This bird has a reputation for eating unusual objects.AdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. PolicyWho does pica affect?Pica can happen to anyone at any age but tends to happen in three specific groups of people:Young children, especially those under 6 years old.People who are pregnant.People with certain mental health conditions, especially autism spectrum disorder, intellectual disabilities or schizophrenia.How common is pica?Pica is a relatively common condition, but experts aren’t sure exactly how common it is. That’s partly because research studies often don’t use the same definition for this condition.It’s also common for healthcare providers to miss the condition entirely. This can happen when people don’t tell their doctor about it or don’t report signs of it in their children.Yet another reason is that infants and young children often put things in their mouths, which is part of their normal development. This kind of pica usually goes away on its own very quickly.AdvertisementHow does this condition affect my body?Pica is a condition where a person compulsively eats things that aren’t food and don’t have any nutritional value. Because it’s compulsive, people with this condition have a very hard time controlling the urge on their own.Pica can have a wide range of effects depending on what non-food item(s) a person eats. For people who eat things like ice — a common behavior for someone who is pregnant — pica is harmless. For others, it can lead to eating dangerous or toxic items.Depending on what you eat, pica can damage your teeth. It can also lead to dangerous problems even when you eat things that aren’t toxic. An example is when people eat hair (known as trichophagia), which can get stuck in their digestive tract, causing blockages, tearing or other damage.Parasites that live in the soil can also infect people who eat dirt or clay (geophagia). People can also contract illnesses from eating feces (poop), especially pet feces that might contain parasites or other germs.Mental health effectsPeople with pica often feel embarrassed or ashamed about this condition. Because of this, people with this condition often don’t seek treatment or are afraid to open up about it to their healthcare provider.Symptoms and CausesWhat are the symptoms of pica?The sole symptom of pica is compulsively eating things that aren’t food or have no nutritional value or benefit. Most people with this condition prefer a single type of non-food item they eat.However, pica can cause other conditions or issues, which have their own sets of symptoms. Other conditions that can happen because of pica include:Anemia (low iron).Ascariasis (roundworm infection).Constipation.Electrolyte imbalance.Irregular heart rhythms (arrhythmias).Lead poisoning.Small intestine and large intestine obstruction/blockage.Common non-food items eatenPeople with pica often eat the following:Ash.Baby or talcum powder.Chalk.Charcoal.Clay, dirt or soil.Coffee grounds.Eggshells.Feces (poop) of any kind.Hair, string or thread.Ice.Laundry starch.Paint chips.Paper.Pebbles.Pet food.Soap.Wool or cloth.AdvertisementWhat causes pica?Experts don’t know exactly why pica happens. However, researchers know certain factors increase the risk of developing it.Cultural or learned behaviors. Certain types of pica are common, socially accepted behaviors in certain cultures and religions. A religious example of this is the practice of eating dirt at El Santuario de Chimayó, a Roman Catholic shrine in New Mexico, USA. A cultural example of this commonly happens in cities in the country of South Africa, where it’s a common practice among young women.Stress or anxiety. Pica might be an outlet or coping mechanism for people with these issues.Negative conditions during childhood. Pica is more common in children living in low socioeconomic situations (such as poverty), but why this happens is unknown. Some possible explanations include that pica is a coping mechanism for children to deal with situations of abuse or neglect. It also might be attention-seeking behavior, especially when one or both parents are absent for any reason.Nutritional deficiencies. People who show signs of pica often have mineral or other deficiencies in their diet. Iron (anemia), calcium and zinc deficiencies are some of the most common reasons people show these signs.Mental health conditions. These include conditions that a person might develop spontaneously, conditions they had at birth because of disruptions in how they developed in the womb and genetic disorders they inherited from their parents.Medical conditions. Pregnancy and sickle cell anemia are two conditions that have connections to pica.Certain medications increase the risk of someone developing pica or similar behaviors. But it’s unknown if these medications actually cause people to develop pica.Diagnosis and TestsHow is pica diagnosed?Diagnosing pica requires four criteria (with the mentioned exceptions explained after the list):Time. The diagnosis requires persistent eating items or substances with no food or nutrition value for at least one month.Mental development. This means a person has developed past a certain point mentally and should know not to eat things that aren’t food or have no nutritional value.No social and cultural factors. This means the person doesn’t have social or cultural background reasons to explain the behavior.No medical or mental health conditions. This means pica isn’t happening because of any other conditions.Reasons to not diagnose picaWhile pica is an extremely common behavior for several reasons, many of those also disqualify diagnosing it. These include:Cultural or social practices. True pica is a compulsive behavior that you can’t control. People with pica behaviors for cultural or social reasons have control of their actions.Nutritional deficiencies. People who have low iron or calcium deficiencies often try to compensate for these by eating non-food items. This is actually why pica is acceptable behavior in some cultures. People in certain places around the world eat clay or soil to make up for a lack of iron, calcium or other vitamins and minerals in their diet.Other medical or mental health conditions. The criteria for diagnosing pica make exceptions for when it happens because of medical and mental health conditions. The only reason to diagnose pica in those circumstances is when it’s severe enough to cause health problems or need specific care.What tests will be done to diagnose pica?Most of the tests for pica are looking for problems that happen because of this condition. These can include a variety of lab, diagnostic and imaging tests, such as:Blood, urine (pee) and stool (poop) tests. These look for signs of infections, poisoning and electrolyte imbalances.Imaging tests. These are looking for any signs of blockage or internal damage from this condition. These can include X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI), ultrasound and more.Diagnostic tests. These tests look for indications of serious health problems that can happen with pica. An example of one of these tests is an electrocardiogram (ECG or EKG), which looks for problems with your heart’s electrical rhythm that can happen with certain electrolyte imbalances or parasitic infections.Management and TreatmentHow is pica treated, and is there a cure?Pica in people who are pregnant usually goes away on its own. Children also usually grow out of pica, especially as someone teaches them the difference between edible and non-edible items and objects. For children with intellectual disabilities (or other problems that interfere with learning), removing problematic items and supervision are both very important.The main form of treatment for pica is therapy, with different therapy methods available depending on the situation and individual needs. A few therapy methods that are possible include:Mild aversive therapy. This method involves teaching people to avoid pica behaviors using mild aversions (consequences) to teach people to avoid non-food items and positively reinforcing (rewarding) healthy eating behaviors.Behavioral therapy. This therapy method involves teaching a person coping mechanisms and strategies to help them change their behavior.Differential reinforcement. In this method, people learn to avoid pica behaviors by focusing on other behaviors and activities.What medications are used?There are very few medications that are likely to help with pica. Antipsychotic medications might help, but the possible side effects usually keep these medications from seeing widespread use.Complications/side effects of the treatmentThere are very few complications that are possible with treatments for pica. If medications are part of the treatment, the possible side effects depend entirely on the medications themselves. Your healthcare provider is the best person to talk to about possible side effects, what to watch for and what you can do to help minimize their impact on your life.How to take care of myself or manage symptoms?Pica is a condition that’s usually benign but can become harmful depending on what a person eats. If you have pica, it’s important to have an honest discussion with your healthcare provider about it. They can offer guidance and resources to help you or refer you to a healthcare provider who has special training in this condition.How soon after treatment will I feel better?The recovery time for pica depends on the treatment and how well you do with it. Your healthcare provider is the person to ask for information about how long it’ll likely take for you to recover and what you can do to help the process happen smoothly.Care at Cleveland ClinicMental Health CareMake an AppointmentPreventionHow can I prevent pica or reduce my risk of developing it?Pica happens unpredictably, so there’s no way to prevent developing it. There’s also no way to reduce your risk of developing this condition.The only thing you can do that relates to pica is to make sure you eat a balanced diet and don’t have any deficiencies in essential vitamins or minerals. While this isn’t exactly prevention or reducing risk, because nutritional deficiencies don’t count toward a pica diagnosis, this is still important overall.Outlook / PrognosisWhat can I expect if I have this condition?Pica is a condition that’s sometimes dangerous on its own, depending on what non-food items a person eats. The main risks with this condition are when people eat items that are:Toxic.Sharp-edged.A risk for blocking your digestive tract.That can cause infections, especially fungi, parasites, bacteria and viruses.How long does this condition last?Pica is technically a life-long condition because it’s not considered curable. People who stop the behavior, either through treatment or who stop on their own, are considered “in remission” as long as they don’t resume the behavior.What’s the outlook for pica?Pica very commonly goes away on its own in children and in people who are pregnant. The condition is usually benign (harmless) for people in these circumstances. The condition itself isn’t dangerous, but it can lead to people eating dangerous items. With treatment, this condition can go into remission, and people can live their lives without difficulty from it.Living WithHow do I take care of myself?If you have pica, talking to your healthcare provider is an important first step in getting help for it. Their job is to help you while also making sure you feel safe and not judged. They can also help by offering you guidance directly or suggesting an expert who can.If you have pica and it’s causing issues that affect your life, it’s important to keep the following in mind:Be honest with your healthcare provider. Pica can be a source of embarrassment or shame for many people. That can make it hard for them to talk about how this condition affects their lives. But pica is a mental health condition, meaning it’s a medical concern, just like a broken arm or a sinus infection. And, like those conditions, it’s good to ask for help and get treatment for this condition.See your healthcare provider as recommended. Your healthcare provider can set up a schedule of visits as needed. As you progress in treatment, you’ll likely need to see them less and less. If this condition starts affecting your life again and you resume pica behaviors, you should return to your healthcare provider and resume treatment.Try to take away items or objects you commonly eat or make it inconvenient to get to them. One way to prevent or reduce pica behaviors is to remove problematic items or objects as much as possible. If removing them isn’t possible, try to make it inconvenient for you to return to pica behaviors.When should I go to the ER?Your healthcare provider can guide you in situations where you might need emergency medical care. Overall, you should seek medical attention if you have symptoms of more dangerous conditions, including the following:Ascariasis (roundworm infection).Electrolyte imbalance.Irregular heart rhythms (arrhythmias).Lead poisoning or other signs of toxic effects.Small intestine and large intestine obstruction/blockage.You should also seek medical attention for children who swallow any potentially toxic or dangerous items. One example of this is any toy that involves small, magnetic objects, which can easily stick together in the digestive tract and cause life-threatening blockages.A note from Cleveland ClinicPica is a very common condition around the world, especially in some circumstances. While it’s usually a condition that people grow out of or stop on their own, for some, it can be a serious problem. The greatest risk is for people who consume items that are toxic, sharp or that can block their digestive tract. Fortunately, mental healthcare treatments and techniques can help this condition go into remission. If you have pica, it’s normal to feel embarrassed about it. But your healthcare provider isn’t there to judge you. Their job is to help you get the care and resources you need to overcome this condition. That way, you can move on with your life and focus on the things that are most important or that you most enjoy.Medically ReviewedLast reviewed by a Cleveland Clinic medical professional on 05/06/2022.Learn more about our editorial process.ReferencesAdvertisementCleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. 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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. StatPearls [Internet].Show detailsTreasure Island (FL): StatPearls Publishing; 2024 Jan-.Search term

PicaYasser Al Nasser; Erind Muco; Ali J. Alsaad.Author Information and AffiliationsAuthorsYasser Al Nasser; Erind Muco1; Ali J. Alsaad2.Affiliations1 Campbell University School of Osteopathic Medicine2 King Faisal universityLast Update: June 26, 2023.Continuing Education ActivityThe American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines pica as eating non-nutritive, non-food substances over a period of at least one month. Additionally, the behavior must not be in keeping with the child's developmental stage and must not be socially normative or culturally acceptable behavior. The nature of ingested items is variable, including but not limited to earth (geophagy), raw starches (amylophagy), ice (pagophagia), charcoal, ash, paper, chalk, cloth, baby powder, coffee grounds, and eggshells. This activity describes the risk factors, evaluation, and management of pica and highlights the role of the interprofessional team in enhancing care delivery for affected patients.

Objectives:

Explain how cultural and social norms can influence the diagnosis of pica.Explain when the diagnosis of pica can be made.List other conditions that can mimic pica.Examine the role of collaboration amongst interprofessional team members to improve care coordination and minimize oversight, leading to earlier diagnosis and treatment and better outcomes for patients with pica.

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IntroductionThe American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines pica as eating nonnutritive, nonfood substances over a period of at least one month. The term is derived from "pica-pica," the Latin word for the magpie bird, because of the bird's indiscriminate gathering and eating a variety of objects for the sake of curiosity.[1] For diagnosis, the behavior must persist for at least one month, not be in keeping with the child's developmental stage (and age cut off of 24 months or more is suggested by DSM V), and not be socially normative or culturally acceptable behavior. The nature of ingested items is variable, including but not limited to earth (geophagy), raw starches (amylophagy), ice (pagophagia), charcoal, ash, paper, chalk, cloth, baby powder, coffee grounds, and eggshells.[2]Although pica is seen in children, it is also a common eating disorder in patients who are intellectually impaired. In women, it is most often seen during pregnancy. In some parts of the world, the consumption of non-nutritive substances is culturally accepted. Pica usually occurs as an isolated disorder but there are instances when it may co-exist with schizophrenia, OCD, and trichotillomania.It is important to understand that in order to diagnose pica, the individual must be at least 2 years of age. It is not unusual to notice that younger children are frequently eating nonnutritive substances.EtiologyMany factors have been implicated in the etiology of pica; however, no direct causality has been established. Studies of psychological factors have reported an association between pica and stress, child neglect and abuse, and maternal deprivation.[3]. Iron deficiency anemia has also been implicated.[4] Many population-based studies have found a low level of serum iron/ferritin (and other micronutrients) among patients with pica.[5][6][7]. Despite this, studies conducted on substances consumed by pica patients failed to show increased iron bioavailability among these substances. This suggests that the idea that these cravings stem from a need for serum iron is an inadequate pathophysiological explanation for this phenomenon.[8] Another proposed hypothesis that is gaining more attention is that pica for non-nutritive substances offers protection from harmful toxins during the most vulnerable stages of human cell replication and embryogenesis (childhood and pregnancy).[9][10][11] The proposed mechanism of protection is binding to toxins and decreasing their intestinal absorption.[12][13][14] In pagophagia, a Japanese study hypothesized that when a patient with anemia chews ice, it increases perfusion thus improving brain function. They contributed that to the activation of the dive reflex which would lead to peripheral vasoconstriction and an increase in central perfusion. Another explanation would be sympathetic activation which would also increase blood flow to the brain.[15]While the causes of Pica remain unknown, some of the risk factors for developing the disorder include the following:StressCultural factorsLearned behaviorLow socioeconomic statusUnderlying mental health disorderNutritional deficiencyChild neglectPregnancyEpilepsyFamilial psychopathologyEpidemiologyA variety of reasons make it challenging to estimate the exact prevalence of pica; for example, studies use variable definitions of pica, under-reporting is common among affected subjects, and a strong cultural and social influence adds further difficulty to detection.[16] For the most part, the condition seems to affect women who are pregnant and young children.[17] A German prevalence study of 804 children found that 99 children (12.3%) have engaged with a pica behavior at some point in their lives.[18] A meta-analysis of studies of the prevalence of pica during pregnancy estimated that 27.8% of pregnant women reported experiencing pica. The study also stated that the sample was heterogeneous throughout the world, with a higher prevalence in Africa compared to other continents.[19] A high prevalence of pica seems to be reported in patients with mental retardation (approximately 10%); it correlates with the severity of mental retardation.[20]History and PhysicalA comprehensive history should be pursued along with caregiver interviews. The details of the exposure should be sought, including the type of substance, amount, duration of exposure, settings where behavior usually happens, the source of the substance, any co-ingestions, and symptoms of toxicity.[21]While, in most cases, the physical exam will be normal,[22] one should look for signs of poisoning or complications. Bezoar ingestion could lead to obstruction and, possibly, ulceration and perforation. Lead poisoning manifests with neurological signs such as lethargy, headache, seizure, encephalopathy, cranial nerve palsy, and papilledema. Infectious agents that could present in clay include Toxocara and Ascaris. Signs of such parasitic infections include fever, cough, myocarditis and encephalitis, hepatomegaly, and visual disturbance.[21][23][24]EvaluationLaboratory evaluation should be tailored according to the suspected substances ingested. Iron studies in patients with pica should be performed, especially in women who are pregnant, and children. Lead (in pica for paint and chalk) and zinc levels should be checked where appropriate.[25] A basic metabolic panel should be obtained, especially in clay ingestion which can cause metabolic disturbances such as hypokalemia.[26]Imaging studies are usually required when patients have abdominal symptoms. This may include plain abdominal x-rays, barium studies, and endoscopy. In many cases, serial studies are needed to ensure that the substance has passed.Treatment / ManagementPrimary prevention should be utilized to identify at-risk patients such as children who live in old homes with lead paint and woman who are pregnant. This could be achieved by screening for the condition among such populations.[27][28][29] Strategies should be utilized to decrease exposure to the craved substance, such as reducing access or providing an appropriate substitute with a similar texture.[30] Iron, zinc, and other nutrient supplementation should be provided when a deficiency is identified.[31][32][33] Behavioral and aversive treatment might be effective in patients with mental disabilities.[34] Differential reinforcement is a commonly used strategy to induce different patient responses to pica by redirecting the undesired behavior to other activities.[35]There are no medications specifically for the treatment of pica. While there are anecdotal reports about antipsychotic use to reduce pica behaviors, these drugs also cause constipation and other adverse effects.Besides the removal of the substance from the environment, it is important to assess the cultural traditions and beliefs that promote pica behavior.Differential DiagnosisCareful screening should be performed for mental health problems in the setting of pica. Several psychiatric illnesses should be considered in the differential diagnosis including other eating disorders, schizophrenia and psychosis, autism and developmental delay in children, substance abuse, and addiction.[36][37]PrognosisPica is usually a benign disorder if it is short-term. In pregnant women and children, the condition spontaneously disappears without any sequelae. However, in individuals with intellectual impairment, it may persist for years. When Pica is long term it can result in bowel obstruction, bezoars, and even toxicity. Ingestion of dirt and paint can lead to infections and heavy metal toxicity. Many reports exist of people who have had to undergo surgery to relieve bowel obstruction, perforation, and ulcers.ComplicationsThe complications of pica can be categorized according to the type of substance ingested:Geophagia: Clay ingestion is a very common form of pica. It can lead to constipation, hypokalemia with myopathy, and nutritional deficiencies.[38][26][39] Clay can also be a source of many infectious agents such as parasites. Lead poisoning can be a serious complication with clay ingestion.Pagophagia: Ice ingestion could lead to iron deficiency, especially during pregnancy.[36] Other complications include tooth decay and sensitivity.[40]Amylophagia: Excessive starch consumption has been associated with iron deficiency. It also can cause high blood sugar and obesity due to its high carbohydrate content.[41]Other substances: Ingested materials can contain a wide variety of toxic contaminants such as lead, mercury, arsenic, fluoride, and many others. Exposure to such items can lead to a wide range of toxic effects such as lead poisoning.[42] Lead poisoning could have dire consequences, particularly among women who are pregnant, and high levels can result in seizures.[43]

Fetal Toxicity

Pica during pregnancy can have dire consequences on the growing fetus. There are case reports of intrauterine toxicity due to maternal pica. Lead poisoning has been implicated in long-term neurological disability.[44] Maternal geophagy has been associated with childhood motor function delay.[45]Enhancing Healthcare Team Outcomes Treatment of patients with pica should utilize an interprofessional team approach. A team consisting of a physician, psychiatrist/psychologist, behavioral therapist, social worker, and dietitian. Patients should be treated in a nonjudgmental manner, with particular attention to their cultural and social background.[46]Patient education is vital. Failure to educate patients on healthy eating habits is a common reason why pica can be prevalent in some populations. Parents need to be educated about the harms of ingesting nonnutritive substances by their children and the need for limiting such exposure. In some jurisdictions, landlords have to ensure that lead-based painting is removed. A dietary consult may benefit some families. Close follow-up by the nurse practitioner may be required to ensure that the pica behavior is not continuing.Clinicians should communicate with each other so that the same message is sent to the parent or caregiver. Review Questions

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References1.Johnson BE. Pica. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Butterworths; Boston: 1990. [PubMed: 21250098]2.Young SL. Pica in pregnancy: new ideas about an old condition. Annu Rev Nutr. 2010 Aug 21;30:403-22. [PubMed: 20420523]3.Singhi S, Singhi P, Adwani GB. Role of psychosocial stress in the cause of pica. Clin Pediatr (Phila). 1981 Dec;20(12):783-5. [PubMed: 7307412]4.López LB, Ortega Soler CR, de Portela ML. [Pica during pregnancy: a frequently underestimated problem]. Arch Latinoam Nutr. 2004 Mar;54(1):17-24. [PubMed: 15332352]5.Nchito M, Geissler PW, Mubila L, Friis H, Olsen A. Effects of iron and multimicronutrient supplementation on geophagy: a two-by-two factorial study among Zambian schoolchildren in Lusaka. Trans R Soc Trop Med Hyg. 2004 Apr;98(4):218-27. [PubMed: 15049460]6.Geissler PW, Shulman CE, Prince RJ, Mutemi W, Mnazi C, Friis H, Lowe B. Geophagy, iron status and anaemia among pregnant women on the coast of Kenya. Trans R Soc Trop Med Hyg. 1998 Sep-Oct;92(5):549-53. [PubMed: 9861377]7.Cavdar AO, Arcasoy A, Cin S, Babacan E, Gözdasoğlu S. Geophagia in Turkey: iron and zinc deficiency, iron and zinc absorption studies and response to treatment with zinc in geophagia cases. Prog Clin Biol Res. 1983;129:71-97. [PubMed: 6657708]8.Hooda PS, Henry CJ, Seyoum TA, Armstrong LD, Fowler MB. The potential impact of soil ingestion on human mineral nutrition. Sci Total Environ. 2004 Oct 15;333(1-3):75-87. [PubMed: 15364520]9.Young SL, Wilson MJ, Miller D, Hillier S. Toward a comprehensive approach to the collection and analysis of pica substances, with emphasis on geophagic materials. PLoS One. 2008 Sep 05;3(9):e3147. [PMC free article: PMC2522275] [PubMed: 18773081]10.Johns T. Detoxification function of geophagy and domestication of the potato. J Chem Ecol. 1986 Mar;12(3):635-46. [PubMed: 24306904]11.Johns T, Duquette M. Detoxification and mineral supplementation as functions of geophagy. Am J Clin Nutr. 1991 Feb;53(2):448-56. [PubMed: 1989412]12.Dominy NJ, Davoust E, Minekus M. Adaptive function of soil consumption: an in vitro study modeling the human stomach and small intestine. J Exp Biol. 2004 Jan;207(Pt 2):319-24. [PubMed: 14668315]13.Khalil SA, Daabis NA, Naggar VF, Motawi MM. The in vitro adsorption of some antibiotics on antacids. Pharmazie. 1976;31(2):105-9. [PubMed: 8784]14.Minnich V, Okçuoğlu A, Tarcon Y, Arcasoy A, Cin S, Yörükoğlu O, Renda F, Demirağ B. Pica in Turkey. II. Effect of clay upon iron absorption. Am J Clin Nutr. 1968 Jan;21(1):78-86. [PubMed: 5237295]15.Hunt MG, Belfer S, Atuahene B. Pagophagia improves neuropsychological processing speed in iron-deficiency anemia. Med Hypotheses. 2014 Oct;83(4):473-6. [PubMed: 25169035]16.Mills ME. Craving more than food: the implications of pica in pregnancy. Nurs Womens Health. 2007 Jun;11(3):266-73. [PubMed: 17883773]17.Young SL, Sherman PW, Lucks JB, Pelto GH. Why on earth?: Evaluating hypotheses about the physiological functions of human geophagy. Q Rev Biol. 2011 Jun;86(2):97-120. [PubMed: 21800636]18.Murray HB, Thomas JJ, Hinz A, Munsch S, Hilbert A. Prevalence in primary school youth of pica and rumination behavior: The understudied feeding disorders. Int J Eat Disord. 2018 Aug;51(8):994-998. [PubMed: 30175409]19.Fawcett EJ, Fawcett JM, Mazmanian D. A meta-analysis of the worldwide prevalence of pica during pregnancy and the postpartum period. Int J Gynaecol Obstet. 2016 Jun;133(3):277-83. [PubMed: 26892693]20.McAlpine C, Singh NN. Pica in institutionalized mentally retarded persons. J Ment Defic Res. 1986 Jun;30 ( Pt 2):171-8. [PubMed: 3735412]21.McNaughten B, Bourke T, Thompson A. Fifteen-minute consultation: the child with pica. Arch Dis Child Educ Pract Ed. 2017 Oct;102(5):226-229. [PubMed: 28487433]22.Screening for elevated blood lead levels. American Academy of Pediatrics Committee on Environmental Health. Pediatrics. 1998 Jun;101(6):1072-8. [PubMed: 9614424]23.Woodhall DM, Garcia AP, Shapiro CA, Wray SL, Shane AL, Mani CS, Stimpert KK, Fox LM, Montgomery SP. Assessment of U.S. Pediatrician Knowledge of Toxocariasis. Am J Trop Med Hyg. 2017 Oct;97(4):1243-1246. [PMC free article: PMC5637614] [PubMed: 28820703]24.Dold C, Holland CV. Ascaris and ascariasis. Microbes Infect. 2011 Jul;13(7):632-7. [PubMed: 20934531]25.Poy MS, Weisstaub A, Iglesias C, Fernández S, Portela ML, López LB. [Pica diagnosis during pregnancy and micronutrient dificiency in Argentine women]. Nutr Hosp. 2012 May-Jun;27(3):922-8. [PubMed: 23114955]26.Ukaonu C, Hill DA, Christensen F. Hypokalemic myopathy in pregnancy caused by clay ingestion. Obstet Gynecol. 2003 Nov;102(5 Pt 2):1169-71. [PubMed: 14607045]27.Roberts JW, Dickey P. Exposure of children to pollutants in house dust and indoor air. Rev Environ Contam Toxicol. 1995;143:59-78. [PubMed: 7501867]28.Hauptman M, Bruccoleri R, Woolf AD. An Update on Childhood Lead Poisoning. Clin Pediatr Emerg Med. 2017 Sep;18(3):181-192. [PMC free article: PMC5645046] [PubMed: 29056870]29.Ezzeddin N, Zavoshy R, Noroozi M, Jahanihashemi H, Riseh SH. Prevalence and risk factors for pica during pregnancy in Tehran, Iran. Eat Weight Disord. 2015 Dec;20(4):457-63. [PubMed: 26143570]30.Matson JL, Hattier MA, Belva B, Matson ML. Pica in persons with developmental disabilities: approaches to treatment. Res Dev Disabil. 2013 Sep;34(9):2564-71. [PubMed: 23747942]31.Roy A, Fuentes-Afflick E, Fernald LCH, Young SL. Pica is prevalent and strongly associated with iron deficiency among Hispanic pregnant women living in the United States. Appetite. 2018 Jan 01;120:163-170. [PubMed: 28864256]32.Sadeghzadeh M, Khoshnevisasl P, Sadeghzadeh S. The relation between pica and iron deficiency in children in Zanjan, Islamic Republic of Iran: a case-control study. East Mediterr Health J. 2017 Aug 20;23(6):404-407. [PubMed: 28836652]33.Kelkitli E, Ozturk N, Aslan NA, Kilic-Baygutalp N, Bayraktutan Z, Kurt N, Bakan N, Bakan E. Serum zinc levels in patients with iron deficiency anemia and its association with symptoms of iron deficiency anemia. Ann Hematol. 2016 Apr;95(5):751-6. [PubMed: 26931116]34.Albin JB. The treatment of pica (scavenging) behavior in the retarded: a critical analysis and implications for research. Ment Retard. 1977 Aug;15(4):14-7. [PubMed: 895511]35.Call NA, Simmons CA, Mevers JE, Alvarez JP. Clinical Outcomes of Behavioral Treatments for Pica in Children with Developmental Disabilities. J Autism Dev Disord. 2015 Jul;45(7):2105-14. [PubMed: 25636679]36.Rabel A, Leitman SF, Miller JL. Ask about ice, then consider iron. J Am Assoc Nurse Pract. 2016 Feb;28(2):116-20. [PMC free article: PMC4635104] [PubMed: 25943566]37.Kar SK, Kamboj A, Kumar R. Pica and psychosis - clinical attributes and correlations: a case report. J Family Med Prim Care. 2015 Jan-Mar;4(1):149-50. [PMC free article: PMC4366992] [PubMed: 25811011]38.McKenna D. Myopathy, hypokalaemia and pica (geophagia) in pregnancy. Ulster Med J. 2006 May;75(2):159-60. [PMC free article: PMC1891740] [PubMed: 16755950]39.Setime MA, Sesay S, Cainelli F, Vento S. A case of severe hypokalemic myopathy due to clay ingestion. Isr Med Assoc J. 2013 Sep;15(9):524-5. [PubMed: 24340849]40.Johnson CD, Koh SH, Shynett B, Koh J, Johnson C. An uncommon dental presentation during pregnancy resulting from multiple eating disorders: pica and bulimia: case report. Gen Dent. 2006 May-Jun;54(3):198-200. [PubMed: 16776414]41.Edwards CH, Johnson AA, Knight EM, Oyemade UJ, Cole OJ, Westney OE, Jones S, Laryea H, Westney LS. Pica in an urban environment. J Nutr. 1994 Jun;124(6 Suppl):954S-962S. [PubMed: 8201446]42.Diawara MM, Litt JS, Unis D, Alfonso N, Martinez L, Crock JG, Smith DB, Carsella J. Arsenic, cadmium, lead, and mercury in surface soils, Pueblo, Colorado: implications for population health risk. Environ Geochem Health. 2006 Aug;28(4):297-315. [PubMed: 16752202]43.Shannon M. Severe lead poisoning in pregnancy. Ambul Pediatr. 2003 Jan-Feb;3(1):37-9. [PubMed: 12540252]44.Mycyk MB, Leikin JB. Combined exchange transfusion and chelation therapy for neonatal lead poisoning. Ann Pharmacother. 2004 May;38(5):821-4. [PubMed: 15026564]45.Mireku MO, Davidson LL, Zoumenou R, Massougbodji A, Cot M, Bodeau-Livinec F. Consequences of prenatal geophagy for maternal prenatal health, risk of childhood geophagy and child psychomotor development. Trop Med Int Health. 2018 Aug;23(8):841-849. [PMC free article: PMC6103800] [PubMed: 29876999]46.Williams DE, McAdam D. Assessment, behavioral treatment, and prevention of pica: clinical guidelines and recommendations for practitioners. Res Dev Disabil. 2012 Nov-Dec;33(6):2050-7. [PubMed: 22750361]Disclosure: Yasser Al Nasser declares no relevant financial relationships with ineligible companies.Disclosure: Erind Muco declares no relevant financial relationships with ineligible companies.Disclosure: Ali Alsaad declares no relevant financial relationships with ineligible companies.

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ViewsPubReaderPrint ViewCite this PageAl Nasser Y, Muco E, Alsaad AJ. Pica. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. In this PageContinuing Education ActivityIntroductionEtiologyEpidemiologyHistory and PhysicalEvaluationTreatment / ManagementDifferential DiagnosisPrognosisComplicationsEnhancing Healthcare Team Outcomes Review QuestionsReferencesBulk DownloadBulk download StatPearls data from FTPRelated informationPMCPubMed Central citationsPubMedLinks to PubMedSimilar articles in PubMedReview Pica Disorder among African American Women: A Call for Action and Further Research.[Soc Work Public Health. 2020]Review Pica Disorder among African American Women: A Call for Action and Further Research.Jackson MS, Adedoyin AC, Winnick SN. Soc Work Public Health. 2020 Jun 1; 35(5):261-270. Epub 2020 Jul 13.Characteristics of Pica Behavior among Mothers around Lake Victoria, Kenya: A Cross-Sectional Study.[Int J Environ Res Public Healt...]Characteristics of Pica Behavior among Mothers around Lake Victoria, Kenya: A Cross-Sectional Study.Chung EO, Mattah B, Hickey MD, Salmen CR, Milner EM, Bukusi EA, Brashares JS, Young SL, Fernald LCH, Fiorella KJ. Int J Environ Res Public Health. 2019 Jul 14; 16(14). Epub 2019 Jul 14.PICA.[Indian J Dent Res. 2012]PICA.Aparna PV, Austin RD, Mathew P. Indian J Dent Res. 2012 May-Jun; 23(3):426-7. Pica and amylophagy are common among Malagasy men, women and children.[PLoS One. 2012]Pica and amylophagy are common among Malagasy men, women and children.Golden CD, Rasolofoniaina BJ, Benjamin R, Young SL. PLoS One. 2012; 7(10):e47129. Epub 2012 Oct 17.Review The Neurology and Psychopathology of Pica.[Curr Neurol Neurosci Rep. 2022]Review The Neurology and Psychopathology of Pica.Schnitzler E. Curr Neurol Neurosci Rep. 2022 Aug; 22(8):531-536. Epub 2022 Jun 8.See reviews...See all...Recent ActivityClearTurn OffTurn OnPica - StatPearlsPica - StatPearlsYour browsing activity is empty.Activity recording is turned off.Turn recording back onSee more...

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PICA在剑桥英语词典中的解释及翻译

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pica 在英语中的意思

picanoun [ U ]

psychology

specialized uk/ˈpaɪ.kə/ us/ˈpaɪ.kə/

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a condition that makes a person or an animal want to eat things that are not food, for example paper or soap, in a way that is not normal: Pica is a compulsive tendency to eat substances other than normal food. Some children have eating problems such as food refusal, selective eating, pica, and overeating.

更多范例减少例句For years before her paper pica appeared, the patient recalled eating a special type of mud which contained a distinctive smell.Geophagia is commonly called clay-eating pica.Pica in dogs may be a sign of immune-mediated haemolytic anaemia.

“SMART 词汇”：相关单词和短语

Mental illnesses

adjustment disorder

age-associated memory impairment

anhedonia

anorexia nervosa

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health anxiety

hoard

hoarder

hoarding

Hyde

manic depression

mental handicap

obsessive-compulsive disorder

psychopathy

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veggie burger

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/ˈvedʒ.i ˌbɜː.ɡər/

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/ˈvedʒ.i ˌbɝː.ɡɚ/

a type of food similar to a hamburger but made without meat, by pressing together small pieces of vegetables, seeds, etc. into a flat, round shape

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