Pica responding to SSRI: an OCD spectrum disorder?

Area of Science:

• Psychiatry
• Neuroscience
• Clinical Psychology

Background:

• Pica is commonly seen in childhood but can indicate underlying conditions in adults, including intellectual disability, psychosis, pregnancy, and rarely, obsessive-compulsive disorder.
• Adult pica cases are infrequently reported, often linked to specific comorbidities or physiological states.

Observation:

• A case study of an adult female patient presenting with an impulse to ingest chalk exclusively during stressful periods.
• The patient experienced ego-dystonic thoughts about eating chalk, which persisted until acted upon.
• Diagnosis included Major Depressive Disorder with relational problems and pica.

Findings:

• Treatment with escitalopram and clonazepam, alongside stress management techniques (ventilating feelings), led to depression improvement within three weeks.
• Remarkable alleviation of pica symptoms was observed concurrently with the improvement in depressive symptoms.
• The findings suggest a potential stress-induced, impulsive/compulsive character of pica in certain adult populations.

Implications:

• Stress may act as a significant trigger for pica in susceptible adults.
• Effective stress management strategies can be a crucial component in treating adult pica.
• Further research into the neurobiological and psychological mechanisms linking stress and pica is warranted.