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Case Reports
. 2021 Sep 14;13(9):e17964.
doi: 10.7759/cureus.17964. eCollection 2021 Sep.

Pica in a Patient With Decompensated Schizophrenia

Xiao Xiong You  1 , Baris Olten  1 , Kunal Gandhi  1 , Saral Desai  1 , Adela Gerolemou  1
Affiliations
Case Reports

Pica in a Patient With Decompensated Schizophrenia

Xiao Xiong You et al. Cureus. .

Abstract

Although pica is commonly associated with nutritional deficiencies, it is also observed in psychiatric disorders such as obsessive-compulsive disorder and less commonly in schizophrenia. We describe a case of pica in a 34-year-old male with decompensated schizophrenia. Emergency medical services brought the patient from a state facility as he was scavenging and eating foreign objects. Upon initial evaluation, no notable nutritional deficiencies were noted. After surgical removal of foreign objects, he was started on antipsychotics. His pica was determined to be due to his active psychosis involving delusions, disorganized thought processes, and loosening of associations. His psychosis improved on paliperidone intramuscular injection and oral olanzapine, which coincided with reduction and resolution of pica. Our case highlights the need to understand further the exact psychopathology of pica that may not be limited to nutritional deficiencies.

Keywords: eating disorders; pica; psychiatry; psychosis; schizophrenia.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. X-ray of the abdomen.
Foreign objects identified in the right lower quadrant of the abdomen.
Figure 2
Figure 2. Colonoscopy procedure.
Colonoscopy images showing foreign objects identified as screws and coins in the cecum.
See this image and copyright information in PMC

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