A Case Report of a Female Patient with Pica

Pica and rumination disorders were moved from the Feeding disorders of Infancy and Early Childhood section of DSM-IV [2] to the Feeding and Eating disorders chapter of DSM-5 [3]. The prevalence of pica is difficult to establish because of differences in definition and the reluctance of patients to admit to abnormal cravings and ingestion. An incidence of Pica greater than 50% is considered normal in children aged 18 to 36 months. Incidence of Pica is thought to decrease with age; one study has revealed that about 10% of children older than 12 years engage in Pica [4]. Pica has been related to mental and emotional disorders. Stressors such as emotional trauma, maternal deprivation and disorganized family are strongly linked to pica as a form of comfort. In a case report published in The World Journal of Biological Psychiatry, Bhatia “et al.” [5] Describes a case of an adult female who had the habit of ingesting chalk only in stressful situations and was diagnosed as having Major Depressive Disorder. According to this article stressful scenarios may induce Pica in some adults and appropriate management of stress may alleviate the symptoms of Pica also [1]. Cases have also been reported in which patients with severe mental handicap have shown worsening of symptoms of Pica during depressive illness [6]. Incidence of Pica has also been linked to iron deficiency, zinc deficiency and certain co-morbid conditions like Kleine-Levin syndrome, mental retardation and schizophrenia. It has been observed in men and women of all ages and ethnicity, but is more prevalent among the lower socioeconomic classes [7]. Another rare form of Pica which has not been much reported is Xylophagia which involves the consumption of substances like paper, pencils, tree barks or other items made of wood. Although most popular form of Xylophagia is the consumption of paper, other forms have also been reported. Here we are reporting a case of Pica secondary to Depression [8].