Abstract
We report about a complex case of pica in comorbidity with multiple sclerosis and binge eating disorder. Pica is classified among the feeding and eating disorders of infancy and early childhood, but there is a debate in the literature about the psychopathology and classification of this behavior. Some authors emphasize the similarities with the obsessivecompulsive spectrum disorders, whereas others propose an interpretation of pica as an addiction or as an impulsive behavior. The clinical case that we describe provides a picture of impulsive and compulsive features that are very difficult to disentangle. It is noteworthy that hypercalcemia is reported to have a protective/therapeutic effect against multiple sclerosis and seems to increase the plasmatic levels of beta-endorphins. The nature, diagnostic classification, and functions of pica are a topic worthy of future investigation.
References
American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4th ed. Text Revision. Washington, DC, American Psychiatric Press, 2000.
Gundogar D, Demir SB, Eren I. Is pica in the spectrum of obsessive-compulsive disorders? Gen Hosp Psychiatry 2003; 25: 293–4.
Rainville AJ. Pica practices of pregnant women are associated with lower maternal hemoglobin level at delivery. J Am Diet Assoc 1998; 98: 293–6.
Horner RD, Lackey CJ, Kolasa K, et al. Pica practices of pregnant women. J Am Diet Assoc 1991; 91: 34–8.
Gupta A, Rajput S, Maduabuchi G, et al. Sponge eating: is it an obsessive compulsive disorder or an unusual form of pica? Acta Paediatr 2007; 96: 1853–4.
Ivascu NS, Sarnaik S, McCrae J, et al. Characterization of pica prevalence among patients with sickle cell disease. Arch Pediatr Adolesc Med 2001; 155: 1243–7.
Simpson E, Mull JD, Longley E, et al. Pica during pregnancy in low-income women born in Mexico. West J Med 2000; 173: 20–4.
Lacey EP. Broadening the perspective of pica: literature review. Public Health Rep 1990; 105: 29–35.
Bhatia MS, Gupta R. Pica responding to SSRI: An OCD spectrum disorder? World J Biol Psychiatry 2009; 10: 936–8.
Edwards CH, Johnson AA, Knight EM, et al. Pica in an urban environment. J Nutr 1994; 124 (Suppl): 954S–62S
Stein DJ, Bouwer C, van Heerden B. Pica and the obsessive-compulsive spectrum disorders. S Afr Med J 1996; 86 (Suppl): 1586–8.
Jacobi C, Hayward C, de Zwaan M, et al. Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions of a general taxonomy. Psychol Bull 2004; 130: 19–65.
Favaro A, Ferrara S, Santonastaso P. The spectrum of eating disorders in young women: a prevalence study in a general population sample. Psychosom Med 2003; 65: 701–8.
Hicks BM, South SC, Dirago AC, et al. Environmental adversity and increasing genetic risk for externalizing disorders. Arch Gen Psychiatry 2009; 66: 640–8.
Favaro A, Ferrara S, Santonastaso P. Self-injurious behavior in a community sample of young women: relationship with childhood abuse and other types of selfdamaging behaviors. J Clin Psychiatry 2007; 68: 122–31.
Heatherton TF, Baumeister RF. Binge eating as escape from self-awareness. Psychol Bull 1991; 110: 86–108.
Brewer JA, Potenza MN. The neurobiology and genetics of impulse control disorders: relationships to drug addictions. Biochem Pharmacol 2008; 75: 63–75.
Becklund BR, Hansen DW Jr, Deluca HF. Enhancement of 1,25-dihydroxyvitamin D3-mediated suppression of experimental autoimmune encephalomyelitis by calcitonin. Proc Natl Acad Sci USA 2009; 106: 5276–81.
Wingerchuk DM, Lesaux J, Rice GP, et al. A pilot study of oral calcitriol (1,25-dihydroxyvitamin D3) for relapsing-remitting multiple sclerosis. J Neurol Neurosurg Psychiatry 2005; 76: 1294–6.
Ofluoglu D, Akyuz G, Unay O, et al. The effect of calcitonin on beta-endorphin levels in postmenopausal osteoporotic patients with back pain. Clin Rheumatol 2007; 26: 44–9.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ceschin, L., Giannunzio, V., Favaro, A. et al. Pica in an eating disordered woman with multiple sclerosis: Impulse dyscontrol, compulsive symptom or self-medication attempt?. Eat Weight Disord 15, e116–e118 (2010). https://doi.org/10.1007/BF03325290
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03325290