Psychiatry and Clinical Psychopharmacology

Is pica classified in OCD spectrum?: a case report

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S110-S111
Read: 3826 Published: 18 February 2021

Pica has been described as persistent ingestion non-nutrient substances for at least one month-period and it has been classified as adult eating disorder instead of child feeding and eating disorder in DSM-V. There are opinions that pica could be classified in Obsessive compulsive disorder (OCD) spectrum or impulse control disorder spectrum. In this case a 19 year-old patient with eating pencil nib for four years was presented. She had started pencil nib eating four years ago and increased step by step because of feeling mental relaxation after eating behavior. If she had eaten pencil nib, she would have relaxed; otherwise she would have craving in her mind, trouble thoughts about something is missed and concentration difficulty. There was no psychiatric family history and EEG and cranial MRG findings were interpreted as normal. In routine tests, iron and vitamin B12 deficiency were determined. The clinical presentation was interpreted as OCD and pica. Iron and vitamin-B12 replacement therapy was started. As the symptoms were persistent after completion of iron and vitamin-B12 replacement treatment; sertraline 50 mg per day and behavioral psychotherapy were administered. On 6-months treatment and follow up visits, it was observed that OCD symptoms and pica, characterized by eating pencil nib, completely improved with sertraline 50 mg per day treatment. In our case, previously unreported pencil nib eating and OCD comorbidity completely responded to sertraline treatment. Although pica is believed to be associated with iron deficiency, in this case pica was not improved despite iron and vitamin B12 replacement. Response of pica and other eating disorders as well as OCD to SSRIs implies that the serotonin system dysfunction was the underlying mechanism in these disorders. As a result this case is supportive data that pica can be a disorder in OCD spectrum.
 

EISSN 2475-0581