Case report: An unusual case of pica

Abstract

Pica is the persistent, culturally and developmentally inappropriate ingestion of non‐nutritive substances (DSM‐IV). AB is a 75‐year‐old lady with a 40‐year history of schizophrenia and a 20‐year history of pica who, at emergency laparotomy, had £175·32 of loose change in her stomach. Although pica has been reported to coexist with schizophrenia, she had had no positive symptoms of schizophrenia for at least 20 years. She has CT evidence of frontotempotal atrophy most marked on the left in the temporal lobe and on the right in the frontal lobe. Pica has been found to be related to cognitive deficits and hyperoral behaviour to temporal lesions. Neuropsychological testing reveals deficits closely related to these changes. © 1998 John Wiley & Sons, Ltd.

A Review of the Forensic Implications of Pica

“…Pica was also found in 26% of patients in one study of 991 institutionalized individuals, with nonfood pica occurring in 17% , although it has been suggested that this high rate was due to a “fairly loose” definition used by the authors . Fronto‐temporal atrophy has been found in some adult patients . The incidence decreases with increasing age and IQ .…”

“…Pica in adults may be a feature of schizophrenia and schizoaffective disorders and may involve the ingestion of a variety of quite bizarre materials . For example, a 75‐year‐old woman with a 40‐year history of schizophrenia and a 20‐year history of pica had ₤175.32 of loose change surgically removed from her stomach . Coprophagia, or the compulsive eating of feces, has been associated with a lethal outcome due to airway obstruction , with affected individuals usually being older adults suffering dementia and significant cognitive impairment .…”

Pica of Adult Onset Presenting as Surgical Emergency

“…In adults, it is commonly associated with pregnancy and may also occur in context to other illness such as autism, mental retardation and schizophrenia. 2 Although foreign body ingestion is common and a benign event, serious complications occasionally require medical or surgical intervention. Successful approaches to treatment are behavioral treatment and treatment of the underlying cause like psychosis.…”

“…Successful approaches to treatment are behavioral treatment and treatment of the underlying cause like psychosis. 2 Timely recognition of the condition and appropriate treatment can avoid the complications.…”

A Right Scrotal Abscess and Foreign Body Ingestion in a Schizophrenic Patient

“…These ingestions are unique compared to those observed in the pediatric population by the sheer number, size, and variety of objects ingested. Reported ingestions by schizophrenic patients include: a wrench, wire-springs, and a razor blade; a large number of coins (461 total); 175 pounds of loose change; a modeling-knife blade; and over 206 bullets (17)(18)(19)(20)(21). They are characterized by the fact that the patient admits to the ingestion only after specific and direct questioning, as in our patient.…”