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Pica is the behavior of eating non-food ingredients without nutritional value, continuously for at least a month. This behavior can be seen with many physical diseases and psychiatric disorders or by itself. This poster presents a case of pica behavior. A 19 years old female patient was admitted to our service, due to destructive behaviors to herself and around. She complained for self-harming behaviors like cutting herself, punching the wall, and feelings of dizziness and blurring in her eyes. She declared that she did not feel any pain because of these harming behaviors. She reported that she was watching her brain out, felt like seeing a gush of blood from her brain. She complained for hearing voices like ‘get up, take the knife, go to the bathroom, etc.’ She stated that she had been trying to get rid of the discomfort of voices by turning up the volume of the television. Her mother declared that the patient fought and cursed other children. For several months she has been eating objects such as glassware, plastic cups etc. and she also hurt herself by these objects. Two months before, olanzapine 10 mg/day, sertraline 50 mg/day and lorazepam 1.25 mg/day treatments were initiated by a psychiatrist. Ten days later she was discharged without any benefit. On mental state examination, she was conscious, cooperated, and oriented. Her speech was clear, and she often gave brief answers to questions. Her affect was appropriate and mood was euthymic. There were uncertain visual and auditory hallucinations. No delusion was detected. Brain MRI and EEG findings were normal. Positive and negative symptoms scale, the Hamilton Depression Rating Scale and the MMPI were applied. Complete blood count and routine biochemical tests were normal. Mild mental retardation (57 points) was detected. No accurate diagnosis was made. The patient’s current treatment was stopped and valproic acid 1000 mg/day, risperidone 2 mg/day, clonazepam 1 mg/day were started. In the course of clinical follow up, psychotherapeutic interviews were conducted with the patient, however she could not adapt to even simple behavioral techniques. She cut her breast and face with plastic cups and said that she had a headache and heard voices, after self-harming she felt relaxed. There was no sign of any improvement in symptoms.. She unscrewed the bed that she was sleeping on. The screw was observed by radiography image in the stomach. She was consulted by a general surgeon, no surgical intervention was applied. During the next days she swallowed new screws, which was observed by radiography. In 7th week of admission to the inpatient clinic, she was discharged with limited medical benefit. The cause and the treatment of Pica behaviors are not well known, and require treatment alone or sometimes together with the underlying disease. Treatment of this disease usually fails; new treatment methods are needed.