Disordered Eating Behavior in a Schizophrenic Patient: a Case of Pica.

Abstract

Introduction

Pica is an eating disorder characterized by eating of nonnutritive materials. It has been reported in different population, from certain ethnic groups, children, pregnant woman or organic disorders (eg. mineral deficiency) to psychiatric patients, including psychotic.

Objectives

To describe a patient who ingest nonfood substances and its relationship with delusions.

Methods

X is a 26 year-old male with Paranoid Schizophrenia who came into the psychiatric emergency service because of an acute exacerbation of his mental illness, presenting auditory hallucinations and delusional mysticism. Draws our attention the presence of an aberrant eating behavior ingesting animals, lime, earth and leaves. The patient was hospitalized in the Impatient Psychiatric Unit for examination and treatment.

Results

Several medical tests were performed and the only finding was an idiopathic eosinophilia, considered secondary to pica. He referred that the ingested items provided him from energy and better sight, as an explanation for his eating behavior. No suicidal ideation was objectified. Neuroleptic treatment was prescribed and behavioral and psychotic symptoms improved progressively.

Conclusions

The etiology of pica is unknown. Schizophrenic motivation for deliberate foreign body ingestion is a poorly understood phenomenon. In the case presented, the ingestions seems to be secondary to delusional beliefs that these objects contains properties that the patient lacks, not obeying to suicidal behavior and objectifying parallel remission of the pica and delusional activity. Further research is needed to clarify the etiology and mechanisms of this disorder, as it can lead to serious medical consequences (eg. metal poisoning, parasitosis, intestinal obstruction).