Chalk eating in middle Georgia: a culture-bound syndrome of pica?

BACKGROUND Although geophagia (earth eating) has been observed and documented in many areas of the world, the specific preference for consuming kaolin is less well known. The ingestion of kaolin, also known as white dirt, chalk, or white clay, is a relatively common type of pica found in the central Georgia Piedmont area. METHODS We reviewed the literature, made informal contacts with Georgia physicians, and arranged semistructured interviews with 21 individuals with a history of chalk eating; we gathered both quantitative and qualitative information. RESULTS Kaolin ingestion appears to be a culturally-transmitted form of pica, not selectively associated with other psychopathology. CONCLUSION Kaolin ingestion appears to meet the DSM-IV criteria for a "culture-bound syndrome."