Symptoms must be present over at least one month and occur repeatedly over one year (APA, 2013). Moreover, the food is only minimally digested and thus still has a pleasant taste. Regurgitation usually seems effortless and is not accompanied by nausea (Stanghellini et al., 2016). The brought-up food is subsequently re-chewed, re-swallowed or spit out. Rumination disorder is characterised by recurrent regurgitation of previously ingested food. Pica behaviour (PB) must not be socially or culturally accepted, and should be severe enough to warrant clinical attention as pica disorder beyond the treatment of comorbid diagnoses (APA, 2013). It is only diagnosed if symptoms have been present for longer than one month and patients show a developmental age of at least 2 years. Potential substances vary greatly, for instance sand, paper or faeces (Leung and Hon, 2019), and craving for the substance can be strong (Young, 2011 Sturmey and Williams, 2016). Pica is defined as the consumption of substances that are neither edible nor nutritious (APA, 2013). Against this background, it is surprising that their prevalence in the general population, comorbid symptom presentation and relations to other eating disorder symptoms in adults have barely been studied. obstructions or perforations of the gastrointestinal tract in pica, and malnourishment in rumination disorder Decker, 1993 Chial et al., 2003 Luoba et al., 2005 Stiegler, 2005). Both disorders can be physically detrimental (e.g. Compared to the former classification in the category Mental Disorders with Onset in Childhood or Adolescence in the DSM-IV (APA, 1996) and the ICD-10 (WHO, 1993), this new prominent placement in the category Feeding and Eating Disorders (DSM-5) and in the category Feeding or Eating Disorders (ICD-11) highlights their potential lifelong relevance. Pica and rumination disorder are two new diagnostic entities in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 American Psychiatric Association, APA, 2013) and the 11th version of the International Classification of Diseases (ICD-11 World Health Organization, WHO, 2021).
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