Pica is a sustained, compulsive eating behavior of nonedible substances. Iron deficiency is commonly associated with pica and it improves with iron supplementation.[1,2] Geophagy (eating of clay) is a common variant of pica. In the context of schizophrenia, pica is believed to be a rare, independent and discrete behavior, which is often missed in the diagnosis and as a result, complications such as intestinal obstruction, electrolyte disturbances, and heavy metal poisoning may occur.
In this case, for which informed consent was obtained, a 22-year-old, divorced, female of lower socioeconomic status presented to the psychiatry outpatients’ clinic with the complaints of increased irritability, aggressive and disruptive behavior, muttering, and smiling to herself, suspiciousness, hearing voices commenting and criticizing her and decreased sleep. These symptoms started 1-year prior, shortly after she was married. Just after her marriage, she had become suspicious of her husband and believed that he was not the same person she had married – she alleged that he was a stranger who had replaced her husband by changing his face. Her persistent suspiciousness toward her husband led to marital discord and divorce, 3 months before presentation. read more here