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Prevalence of pica and rumination behaviors in German children aged 7–14 and their associations with feeding, eating, and general psychopathology: a population-based study

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Abstract

Despite potentially severe medical consequences of pica and rumination disorder (RD), little is known about their prevalence and association with other psychopathology in childhood. As a part of a larger population-based study, 804 children aged 7–14 years and their parents were asked about their experience of pica and RD behaviors, and associated eating, feeding and general psychopathology. A total of 12.31 and 11.49% of the participants reported having engaged in pica or RD behaviors, respectively, at least once. Recurring pica or RD behaviors had been experienced by 4.98 and 1.49% of the participants, respectively. The behaviors showed a significant but small correlation with one another (r = 0.28, p < 0.01). Correlations with symptoms of avoidant/restrictive food intake disorder (ARFID) were significant but small (pica: r = 0.18, RD: r = 0.27, both p < 0.01). Prevalence rates of recurring pica behavior were significantly increased if recurring RD was present (58.33%), and also vice versa (17.50%). The prevalence rates of recurrent pica and RD behaviors were also increased in the presence of an ARFID diagnosis (both behaviors 12.0%). However, correlations with restraint and eating, weight, and shape concern were non-significant (all p > 0.05). Additionally, RD behavior was positively correlated with emotional and conduct problems (r = 0.15 and 0.22, both p < 0.01), and both behaviors were negatively correlated with prosocial behavior (r = −  0.10 and − 0.09, both p < 0.05). Our findings underscore the clinical significance of pica and RD behaviors. More research is warranted on both disorders and their association and relation with ARFID to deepen the understanding of their presentation and to ascertain diagnostic validity.

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  • 08 June 2018

    n the original publication, under the discussion section.

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Acknowledgements

This publication is supported by LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, funded by means of the European Union, the European Social Fund (ESF), the European Regional Development Fund (ERDF), and the Free State of Saxony within the framework of the excellence initiative. Anja Hilbert is funded by the German Federal Ministry of Education and Research (Grant 01EO1501). The authors are very grateful to all participating families and to the LIFE Child Study Team.

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Authors and Affiliations

  1. Institute of Psychology, Department of Human Sciences, Osnabrück University, Knollstrasse 15, 49069, Osnabrück, Germany

    Andrea S. Hartmann

  2. LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany

    Tanja Poulain, Mandy Vogel, Andreas Hiemisch & Wieland Kiess

  3. Center for Pediatric Research, Hospital for Children and Adolescents, University of Leipzig Medical Center, Liebigstrasse 20a, 04103, Leipzig, Germany

    Tanja Poulain, Mandy Vogel, Andreas Hiemisch & Wieland Kiess

  4. Department of Medical Psychology and Medical Sociology, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany

    Anja Hilbert

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  1. Andrea S. Hartmann
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Correspondence to Andrea S. Hartmann.

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Hartmann, A.S., Poulain, T., Vogel, M. et al. Prevalence of pica and rumination behaviors in German children aged 7–14 and their associations with feeding, eating, and general psychopathology: a population-based study. Eur Child Adolesc Psychiatry 27, 1499–1508 (2018). https://doi.org/10.1007/s00787-018-1153-9

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