Why do I keep eating paper

Pica syndrome

Pica syndrome: description

The pica syndrome is a mental illness belonging to the group of eating disorder. In contrast to anorexia, bulimia (eating-vomiting addiction) and binge-eating syndrome, the focus in pica syndrome is not the amount but the type of substances consumed: those affected mainly eat things that are considered inedible, for example sand, paint, hair, soap, ice, starch, mortar or paper. The term Picacism originally referred to the unusual eating habits of pregnant women, but is now used synonymously for pica syndrome. "Pica" is the Latin name of the magpie, which is considered a greedy and not particularly picky bird.

Pica syndrome - a rather rare eating disorder

Pica syndrome primarily affects young children and is defined as behavior that is not appropriate for the respective stage of development. Usually, pediatricians and psychologists do not diagnose before the age of two. Pica syndrome is rare in adults, and women are more likely to be affected than men. Especially during pregnancy, some women from poor backgrounds tend to have an eating behavior that comes close to pica syndrome. However, a culturally or religiously conditioned eating behavior must be distinguished from this, such as the eating of certain types of earth (geophagy) in certain indigenous peoples.

Pica syndrome: symptoms

The main symptom of pica syndrome is that those affected ingest substances that are actually not suitable for consumption. The range here is wide - while some are quite affected certain preferences and eat only one type of clay, for example, children with pica syndrome sometimes devour everything they can put in their mouths. The behavior can be shown secretly and shamefully, completely naturally and downright demonstratively. Other eating habits and the appetite for common foods are unchanged in most of them.

Some substances are used by people with pica syndrome especially often consumed:

  • Clay and earth (geophagy)
  • Ice cream (pagophagia)
  • Starch (amylophagia)
  • Feces (coprophagia)
  • Hair (trichophagia)
  • Wood / paper (xylophagia)
  • chalk
  • colour

Sometimes pica syndrome can be accompanied by or as a result of certain nutrient deficiencies, for example zinc deficiency or iron deficiency anemia.

Pica syndrome: causes and risk factors

Pica syndrome can have various causes. The following risk factors are known in young children:

  • decreased intelligence
  • psychosocial stress
  • Disorders of the mother-child relationship

Child and adolescent psychologists explain the Pica syndrome as either a learned misconduct or the affected children take a step back in their development due to stressful situations. Occasionally, however, otherwise completely inconspicuous children have a preference for eating paint, dust or other substances. The behavior increases when the children grow up in a low-irritant environment and are bored.

The pica syndrome in adults

Besides people with serious underlying psychiatric illnesses - especially schizophrenia and dementia - among the adults, mostly pregnant women are affected by pica syndrome. The women affected eat clay and ice particularly often. According to various studies, the percentage is apparently significantly higher in women who live in very poor conditions than in pregnant women from well-nourished parts of the population. One theory is that different Nutritional deficiencies can trigger cravings for inedible substances; suggests that there is an obvious connection between pica syndrome and iron deficiency during pregnancy. However, this thesis is not secure. So far there is also no evidence of a hereditary predisposition to pica syndrome.

Pica syndrome: examinations and diagnosis

The diagnosis of Pica syndrome can be made by a psychiatrist, psychotherapist, pediatrician, child psychologist or general practitioner. The most important thing is a detailed one anamnese, i.e. a conversation with the person concerned or - in the case of small children or people with mental disabilities - with a relative. The doctor asks, for example, what exactly the person concerned consumes in which situations and in which quantities, and what other eating habits look like. Known physical and mental illnesses, a possible pregnancy and nutritional deficiencies are also clarified as part of the anamnesis.

If the doctor or psychotherapist suspects another underlying mental illness, he or she may ask further specific questions or have the patient fill out certain questionnaires and tests (e.g. dementia or schizophrenia tests).

Physical exams for pica syndrome

First of all, the doctor gets an idea of ​​whether the person concerned is malnourished or shows certain deficiency symptoms. He monitors the patient's body weight and looks for various symptoms that indicate nutritional deficiencies, such as paleness and hair loss. If the person concerned consumes pure starch permanently (amylophagia), this can lead to iron deficiency anemia; Children and adults who ingest paint or other substances that contain lead also run the risk of chronic lead poisoning. A Blood test creates certainty about nutrient deficiencies, elevated lead levels and other shifts caused by pica syndrome.

Imaging procedures such as a X-ray examination are necessary if the person concerned has swallowed indigestible objects (e.g. nails). Eating hair (trichophagy) can also be dangerous, because they often form indigestible tangles in the intestine - so-called bezoars. These are only visible on the X-ray with a contrast medium.

Read more about the examinations

Find out here which examinations can be useful for this disease:

Pica syndrome: treatment

Since the backgrounds of pica syndrome are extremely diverse, there is no standard therapy for this eating disorder. The treatment depends on the age of the person affected and the individual severity and cause of the symptoms. Therapies that can be helpful are:

  • For babies and toddlers with pica syndrome, the first measure is one careful supervision. Anything that the child could potentially see as edible should be kept out of their reach.
  • If, for example, people with pica syndrome have an iron or zinc deficiency, it is important to correct the nutrient deficiencies through a rich diet and as a supportive therapy Food supplements balance. This is especially true for pregnant women.
  • Goal one Behavior therapy it is that those affected learn to abandon their pathological eating behavior and instead, for example, resort to alternative behaviors or foods. Behavioral therapy is always useful for people who have had pica syndrome for a long time and have become obsessive.
  • Children and adults with pica syndrome who have severe limitations in their intelligence and general development need one according to their needs curative educational support - for example in living, school and work areas.
  • In the case of underlying mental illnesses or accompanying illnesses such as depression, schizophrenia or dementia, it is important that these illnesses are treated with psychotherapy and, if necessary, medication. In individual cases it has been shown that modern antidepressants (Serotonin reuptake inhibitors) can have a positive effect on therapy in pica syndrome.

Pica Syndrome: Prevention

Pica syndrome is a rare condition for which there is no specific prevention. However, the risk can be greatly reduced in infancy and toddlerhood if the child has an intact bond with its mother, is accustomed to eating suitable foods normally, and is sufficiently mentally stimulated, for example through activity and suitable toys. Children with intellectual disabilities and developmental delays may need appropriate special educational care.

In adulthood it is important to keep an eye on and promote your own health on a physical and mental level. If psychological problems arise, do not be afraid to seek advice from a professional (psychiatrist or psychotherapist). Also, make sure you eat a rich and balanced diet. In consultation with your doctor, you can counteract severe nutritional deficiencies with specific dietary supplements. So can both physical deficiency symptoms and the Pica syndrome prevent.

Read more about the therapies

Read more about therapies that can help here:

Pica syndrome: disease course and prognosis

Consumption of unsuitable substances can cause digestive problems, poisoning and infections in those affected. A long-lasting and pronounced pica syndrome can also lead to malnutrition with a lack of vitamins and minerals.

The course of the pica syndrome varies. In some cases it is a temporary behavior disorder, while some patients show this disordered eating behavior for a lifetime. In any case, it is important to have one Pica syndrome treat as early as possible.

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