Pica in various psychiatric disorders

Abstract

Pica is the prolonged, compulsive consumption of inedible objects. Pica is sometimes attributed to an iron deficiency, and it gets better with iron supplements. Typical kind of pica is geophagy or eating clay. Apart from nutritional deficiencies, it is also seen in psychiatric disorders such as obsessive–compulsive disorder. Pica is thought to be a rare, autonomous, and separate habit in the context of schizophrenia, which is frequently ignored in the diagnosis and may lead to consequences such as intestinal obstruction, electrolyte imbalances, and heavy metal toxicity. Here, we are going to discuss a case of a 25-year-old female. She came with complaints of pain abdomen and undergone routine X-ray abdomen which showed ingested three nails. She was admitted under general surgery care. After the evacuation of nails, she undergone psychiatric evaluation. She has faint memory of nail ingestion but discussed stressful interpersonal relationship with her husband and managed on antidepressant medication. Her pica was probably due to interpersonal conflict with her husband few days ago. Her anxiety and sadness improved significantly with the tablet escitalopram and etizolam. In this case, we are trying to understand the psychopathology of pica, other than medical and known psychiatric causes.