Pica in an eating disordered woman with multiple sclerosis: impulse dys-control, compulsive symptom or self-medication attempt?
We report about a complex case of pica in comorbidity with multiple sclerosis and binge eating disorder. Pica is classified among the feeding and eating disorders of infancy and early childhood, but there is a debate in the literature about the psychopathology and classification of this behavior. Some authors emphasize the similarities with the obsessive-compulsive spectrum disorders, whereas others propose an interpretation of pica as an addiction or as an impulsive behavior. The clinical case that we describe provides a picture of impulsive and compulsive features that are very difficult to disentangle. It is noteworthy that hypercalcemia is reported to have a protective/therapeutic effect against multiple sclerosis and seems to increase the plasmatic levels of beta-endorphins. The nature, diagnostic classification, and functions of pica are a topic worthy of future investigation.
Ceschin
L
L
Department of Neurosciences, University of Padua, 35128 Padua, Italy.
Giannunzio
V
V
Favaro
A
A
Santonastaso
P
P
D056912:Binge-Eating Disorder / Q000150:complications*; D003192:Compulsive Behavior / Q000150:complications / Q000175:diagnosis; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D010842:Pica / Q000150:complications* / Q000175:diagnosis