Cases That Test Your Skills

A taste for the unusual

Current Psychiatry. 2013 March;12(3):46-49

References

1. Diagnostic and statistical manual of mental disorders, 4th ed, text rev. Washington DC: American Psychiatric Association; 2000.

2. Patton W, Gibbs K. Cardboard bezoar complicating laparoscopic gastric bypass. Surg Obes Relat Dis. 2010;6(3):313-315.

3. Nurcombe B. Developmental disorders of attachment feeding, elimination, & sleeping. In: Ebert MH, Loosen PT, Nurcombe B, et al, eds. CURRENT diagnosis & treatment: psychiatry. 2nd ed. New York, NY: McGraw Hill; 2008.

4. Kushner F, Gleason B, Shanta-Retelny V. Reemergence of pica following gastric bypass surgery for obesity: a new presentation of an old problem. J Am Diet Assoc. 2004;104(9):1393-1397.

5. Kushner F, Shanta Retelny V. Emergence of pica (ingestion of non-food substances) accompanying iron deficiency anemia after gastric bypass surgery. Obes Surg. 2005;15(10):1491-1495.

6. Marinella MA. Nocturnal pagophagia complicating gastric bypass. Mayo Clin Proc. 2008;83(8):961.-

7. Bernstein B, Weinstein M. Normal pregnancy & prenatal care. In: DeCherney AH Nathan L, Goodwin TM, et al, eds. CURRENT diagnosis & treatment obstetrics & gynecology. 10th ed. New York, NY: McGraw Hill; 2007.

8. Piazza C, Fisher W, Hanley P, et al. Treatment of pica through multiple analyses of its reinforcing functions. J Appl Behav Anal. 1998;31(2):165-189.

9. Williams DE, McAdam D. Assessment behavioral treatment, and prevention of pica: clinical guidelines and recommendations for practitioners. Res Dev Disabil. 2012;33(6):2050-2057.

10. Blinder BJ, Salama C. An update on pica: prevalence contributing causes, and treatment. Psychiatric Times. http://www.psychiatrictimes.com/display/article/10168/1159376?pageNumber=1. Published May 1, 2008. Accessed January 23, 2013.

11. Lerner AJ. Treatment of pica behavior with olanzapine. CNS Spectr. 2008;13(1):19.-

Table

Behavioral interventions for pica

Intervention	Comments
Environmental enrichment	Providing additional stimulus to increase neuronal activity and focus behaviors
Noncontingent reinforcement	Presenting reinforcers according to a fixed schedule
Differential reinforcement	Desired behaviors are reinforced and inappropriate behaviors are ignored
Response blocking	Physically block a patient’s attempts to eat nonedible items
Source: Reference 8

Related Resources

Blinder BJ, Salama C. An update on pica: prevalence, contributing causes, and treatment. Psychiatric Times. www.psychiatrictimes.com/display/article/10168/1159376?pageNumber=1. Published May 1, 2008.
Nurcombe B. Developmental disorders of attachment, feeding, elimination, & sleeping. In: Ebert MH, Loosen PT, Nurcombe B, et al, eds. CURRENT diagnosis & treatment: psychiatry. 2nd ed. New York, NY: McGraw Hill; 2008.

Drug Brand Names

Buprenorphine • Subutex
Bupropion • Wellbutrin, Zyban
Chlorimipramine • Anafranil
Esomeprazole • Nexium
Fluoxetine • Prozac
Lorazepam • Ativan
Olanzapine • Zyprexa
Ziprasidone • Geodon

Disclosure

The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

A taste for the unusual

References

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