Prevalence of pica and rumination behaviours in adults and associations with eating disorder and general psychopathology: findings form a population-based study

Abstract

Aims Pica and rumination disorder are known as feeding disorder diagnoses in childhood, but little is known about their occurrence in adulthood. This study aimed to assess prevalence rates of one-time and recurrent pica and rumination behaviours (PB and RB) in adults, including sociodemographic subgroups, and to examine associations with other eating disorder and general psychopathology. Methods The representative population sample (N = 2403) completed measures on PB and RB, symptoms of avoidant/restrictive food intake disorder (ARFID), body image and symptoms of depression and anxiety. Results Any PB and RB were reported in 5.33 and 5.49%, respectively, while recurrent PB or RB occurred in 1.08 and 0.71%, respectively. Co-occurrence was high, with 35.29% of recurrent PB in RB, and 23.08% vice versa. Prevalence rates of recurrent PB or RB did not differ by gender, weight status, educational or migration history from those without recurrent behaviours. Adults with v. without recurrent PB and RB showed more symptoms of ARFID, general eating disorders depression and anxiety, and behavioural symptoms of eating disorders (with the exception of compensatory behaviours in recurrent PB), and less positive body image. However, there were no differences regarding age and body mass index. Conclusions Our findings highlight the clinical significance of PB and RB in adults regarding both prevalence and associations with other psychopathological symptoms. In particular, associations with body image need to be investigated further, as in contrast to other eating disorders, body image disturbance is not yet represented in the diagnostic criteria for pica and rumination disorder. In sum, the findings highlight the need for clinical attention for these disorders and related behaviours in adults.

Prevalence and recurrence of pica behaviors in early childhood within the ALSPAC birth cohort

“…One option for screening pica in clinical settings would be the Pica, ARFID, and Rumination Disorder Interview (PARDI; Bryant‐Waugh et al, 2019), which is designed for individuals ages 2+ and has demonstrated robust psychometric properties. We did not find evidence that pica behaviors and BMI were associated, similar to findings reported by Hartmann et al (2022), who reported no BMI differences in adults who exhibit long‐term pica behaviors relative to those who do not. These findings show that children of all sizes, shapes, and weights may exhibit pica behaviors alongside broader eating difficulties, and this is a salient point for primary care providers who are essential to eating disorder screening and detection (Voss, 2022).…”

“…The prevalence of pica behavior within the ALSPAC cohort is lower than that reported in adults (5.5% of adults; Hartmann et al, 2022), but broadly similar to that reported in other samples of children (3.5%; in the population‐based control group; Fields et al, 2021). The higher percentage of adults endorsing pica behaviors reported by Hartmann et al (2022) may be explained by differences in pica measurement. In the present study, pica frequencies are reported by the child's caregiver, who observed pica behavior over the five time points assessed.…”

“…Hartmann et al, 2022), but broadly similar to that reported in other samples of children (3.5%; in the population-based control group;Fields et al, 2021). The higher percentage of adults endorsing pica behaviors reported byHartmann et al …”

“…In contrast, Hartmann et al used a 7‐point Likert scale where 0 indicated “never true,” and six indicated “always true.” Pica behavior was defined as any respondent who endorsed 1–6 on this Likert scale. Pica measurement used in Hartmann et al (2022) may have led to higher pica reports since scores of 1–3 reflected subthreshold pica behaviors (where 0 is no pica and scores of 4–7 indicate pica).…”

Prevalence and Recurrence of Pica Behaviors in Early Childhood: Findings from the ALSPAC Birth Cohort

“…(5.5% of adults; Hartmann et al, 2022), but broadly similar to that reported in other samples of children (3.5%; in the population-based control group; Fields et al, 2021). The higher percentage of adults endorsing pica behaviors reported by Hartmann and colleagues ( 2022) may be explained by differences in pica measurement.…”