![]() ![]() They contributed to the activation of the dive reflex which would lead to peripheral vasoconstriction and an increase in central perfusion. In pagophagia(ingestion of ice), a Japanese study hypothesized that when a patient with anemia chews ice, it rises perfusion and improves brain function. 14 In animal studies, cisplatin can induce pica behavior in specific strains in mice. ![]() 1 Occasionally, pica may be associated with medications such as risperidone, olanzapine, and tramadol. Pet-keeping motivates pica as children may eat pet food by imitation. 13 This suggests that the idea that these cravings arise from a need for serum iron is an inadequate pathophysiological explanation for this phenomenon. 11, 12 However, a study conducted with substances consumed by patients with pica has not shown an increase in the bioavailability of iron among these substances. Many population-based studies have observed low serum iron/ferritin and other micronutrients among patients with pica. Iron deficiency anemia has an implicated hand. And the mentally disabled child remains at a more infantile developmental level for longer than the normal child. Thus, abnormalities in the eating center of the hypothalamus may result in pica in some individuals. Lesions in the hypothalamus and anterior cingulate gyrus may lead to hyperphagia. 1 Moreover, relief of anxiety and emotional stress in the child by oral gratification is often a psychological response to an absent or poorly functioning mother. There is some evidence that pica is an attention-seeking device the high incidence of working mothers and families with young children may suggest this behavior. There is not a direct cause for pica, but there are many risk factors such as child neglect, stress, maternal deprivation, low socioeconomic status, etc. 2 A high prevalence of pica seems to be reported in patients with mental retardation, almost 10% it correlates with the severity of mental retardation. And even the prevalence rate of pica could be as high as 77% in African children. The study also declared that the sample was heterogeneous throughout the world, with a higher prevalence in Africa compared to other continents. 1 A meta-analysis of studies on the prevalence of pica during pregnancy showed that 27.8% of pregnant women reported experiencing pica. 1, 7Ī German prevalence study of 804 children observed that 12.3% of children have been associated with pica behavior at some point in their lives. ![]() Children with sickle cell anemia are at greater risk for developing pica than those without sickle cell anemia. 6 The incidence is increased in children whose siblings or mothers have pica before. And it is more common among children in lower socioeconomic classes, immigrants, and refugees. The percentage of prevalence decreases with age. It is also more common in blacks than whites. Pica is a little more common in boys than girls. 1 Although pica is more occurrence than is expected either because the condition may be overlooked by physicians or under-reported by patients or parents. It is difficult to evaluate the exact prevalence of pica because of different studied populations, cultural practices, regional differences, under-reporting, etc. 1 However, pica usually occurs as an isolated disorder, some states occur with schizophrenia, autistic spectrum disorder, attention-deficit hyperactivity disorder, depression, OCD, and trichotillomania. Pica is common in children between 18 months to six years, women during pregnancy, and intellectually impaired persons. And for diagnosis, this behavior must last for at least one month, also not be in keeping with the child’s developmental stage, and not be socially normative or culturally acceptable. Pica refers to the persistent, compulsive craving to ingest inedible substances. 1 And the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines a pica as eating nonnutritive, nonfood substances over a period of at least one month. The term “Pica” has come from “pica-pica” the Latin word for the magpie bird because of gathering and eating a variety of objects for curiosity. Keywords : pica, pagophagia, iron deficiency, lead poisoning Introduction Editor: Ihdaa Mahmoud Bani Khalaf, Sadeen Eid ![]()
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