pica actually refers to the latin word for magpie , a bird thought to have odd feeding habits .
incidence of pica has also been linked to iron and zinc deficiency . whether the pica is an eating disorder or obsessive compulsive disorder is still controversial .
the patient was a 27 year old young indian lady living in the baruipur with no previous psychiatric or medical history .
patient complained of an unusual sensation in her abdomen for the last 3 months while her parents gave a history of habitual consumption of nails for the same duration .
the patient was a single child to her parents and she was living in the suburbs since her birth .
she had attended public schools and had completed her graduation on arts from a college in kolkata .
soon after her marriage , she expressed sexual aversion with history of dyspareunia . within a month of her marriage , she found it extremely difficult to live in her in - laws house and preferred to stay at her parental home , although her parents repeatedly insisted her to go back to her in - laws residence .
depressed and also admitted that for the last 3 months , she was having a sense of hopelessness and worthlessness over her future days .
vanished. she temporarily enjoyed the gritty and spiky sensation of nails along her throat , but at night she used to have a vague abdominal sensation which she described to be 
funny. according to her mother , she did not want to go back to live with her husband . on close interviewing of the patient , initially her response to same- sex relationship was guarded but later it was found that she was actually having such a relationship with another lady of her age for the past 3 years .
she also accepted that she used to consume glass piece occasionally since last 3 years but never disclosed them to anyone .
she had once had an x - ray of her abdomen done 2 years back due to complaints of low back pain which was inconclusive ; perhaps glass beads which are radiolucent were missed . no further investigation was done .
the patient was decently dressed in a pastel shade salwar with a boyish cut hairstyle . on mental state examination
on interviewing the husband , it was known they had never had any sexual intercourse since marriage .
on routine examination , possibility of iron deficiency anemia , serum ferritin abnormality and zinc deficiencies were ruled out .
x ray of abdomen showed multiple radio opaque pointed objects in her gut ( ingested iron nails ) .
the patient had been nurtured in an overprotected environment by her parents in her early childhood days .
however immediately following her high school , she had to take many responsibilities of the family all of a sudden because of loss of job of her father .
she was more bonded to her mother and in the elderly , often avoided her father because he was alcoholic .
the cultural , psychodynamic , and physiological aspect of this case is a unique one . the patient 's initial experimentation with ingestion of glass beads , though in a very remote sense , may be culture based considering the fact that the practice of ingesting such beads and sharp metallic objects has been reported .
considering the fact that the patient was initially nurtured in an overprotected environment by her parents and suddenly being exposed to a comparatively hostile situation where she found a discouraging picture of the members of the opposite sex from that of her alcoholic father , the patient 's inclination toward same - sex relationship can be explained .
psychologically , the inclination of the patient toward same sex relationship and her unfamiliarity and uneasiness with the members of the opposite sex led to marital dissatisfaction . also ,
since the patient had to take many burdens of her family at an age which may be considered quite an early one considering the indian standards and her socioeconomic profile , this probably has caused her to resort to some , harsh robust means like  ingestion of nails which may have been an act to depict her 
her intelligent quotient as measured by wechsler 's adult intelligence scale had been found to be 98 which fall in normal age .
as in most cases of pica , she initially did not come with a complaint of pica .
rather , she had reported to the hospital with complaints of unusual sensation in her abdomen .
the present case presented a unique conglomeration of cultural , psychodynamic , and physiological determinants which together contributed to the expression of pica in comparison with previous reports and reviews . however , an interesting fact in this case is the age of the patient which is quite unusual for pica to occur .
this perhaps necessitates further research in dealing with the epidemiology and other aspects of this quite rare but interesting disease entity .
 pica has been considered as the ingestion of inedible substances or atypical food combinations . 
 pica has been reported widely in pediatric age group and often found to be co existing with obsessive compulsive or major depressive disorder . 
 reports of pica in elderly age group are relatively uncommon and rarely does it have an adult onset . in this article we present a case of adult onset pica . a young lady with unusual sensation in her abdomen 
 was found to consume iron nails over years and there was history of dyspareunia since her marriage three months back . on query 
 it was known that the lady is having same sex relationship over years . there 
 unique conglomeration of cultural , psychodynamic and physiological determinants which together is responsible for this unusual habit of this lady . 
 moreover the onset of the disease at a late age and different psychodynamic issues make the case all the more interesting . whether the pica is an eating disorder or 
 obsessive compulsive disorder is still controversial . 
 pica has been mentioned in diagnostic and statistical manual iv tr . 
 the present case report warrants the need to look into this entity more closely with regards to its occurrence and etiology . 