Pica in the Geriatric Mentally Ill: Unrelenting and Potentially Fatal

Abstract

Pica has rarely been reported in patients with geriatric mental illness. The authors describe 3 male patients with pica in the geriatric unit of a state mental hospital. Two of these patients had a diagnosis of developmental delay with concomitant diagnoses of schizophrenia and schizoaffective disorder, respectively. The third patient was diagnosed with paranoid schizophrenia. In all 3 cases, pica started late in life and was unrelenting and unresponsive to psychotropic medications, with limited to no response to behavioral interventions. In the 2 patients who died, pica was implicated as the direct cause of death in 1 and the likely cause of death in the other. When pica occurs in elderly patients with mental illness, the risk of mortality should be taken into account in clinical management. (J Geriatr Psychiatry Neurol 2003; 16:189-191).