A gifted 22-year-old American man, once a high-achieving student on a full college scholarship, was recently reported to have exhibited extreme and bizarre behaviors—including the consumption of his own feces—due to the onset of schizophrenia.
The case was published by the Department of Psychiatry and Behavioral Sciences at the University of Texas Health Science Center at Houston (UTHealth) in the journal Psychiatry Research Case Reports. According to the medical staff, the man had no significant mental or physical health history prior to these events and had earned his scholarship through excellent academic performance in high school.
A Sudden and Dangerous Descent into Pica
The patient’s unusual symptoms began in early 2022. In February, he was hospitalized for abdominal pain, nausea, and vomiting, eventually being diagnosed with a small bowel obstruction. While the cause was not confirmed at the time, medical staff now suspect the obstruction was the result of pica—the persistent consumption of non-food items.
By June of that year, the man was admitted to the emergency room after swallowing metal objects, feces, and flakes of his own skin. Alongside these behaviors, he exhibited severe paranoia, believing that others were attempting to harm or deceive him. His family reported other disturbing changes, such as the man sleeping outdoors with dogs or spending the majority of his time locked in the bathroom. These events led to his involuntary transfer to a mental health facility in July.
Delusions of Digestion and Immunity
During his initial interviews with psychiatric staff, the man claimed he had eaten dog feces and plastic to "aid his digestion." He also suffered from delusions of reference, believing that unknown cameras were monitoring his movements and that his private thoughts were being broadcast on television.
The patient later revealed that he had been consuming feces for eighteen months and believed the behavior was a form of "self-improvement" aimed at securing immunity. He told doctors that he only felt "complete" when consuming non-food items. During his hospitalization, his behavior turned aggressive when staff attempted to stop him from eating plastic, paper, feces, and urine. He also exhibited bizarre hygiene rituals, such as eating soap after consuming feces or applying excessive amounts of hand sanitizer to his face.
Treatment and Recovery
The medical staff ultimately diagnosed the man with pica secondary to schizophrenia. They noted that in this case, the eating disorder likely stemmed from the patient's psychotic delusions that consuming such items was beneficial to his health.
Fortunately, through targeted medication treatment, the patient’s anxiety improved and his pica attempts decreased significantly. He was discharged approximately one month after admission.
"This case demonstrates that pica can appear as a secondary symptom of schizophrenia, driven by delusional beliefs," the medical team explained. They emphasized that abnormal eating behaviors in psychotic patients can be alleviated through proper medication and that clinicians must actively assess for eating disorders when treating those with psychotic symptoms.
Schizophrenia is a complex psychiatric disorder that disrupts thought, perception, and emotion, often manifesting as hallucinations and delusions. It is primarily treated with antipsychotic medications that regulate dopamine signals to restore reality judgment and reduce psychotic behaviors.
