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Xylophagia: a meta-synthesis of the literature

Fahad Riaz Choudhry (Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur, Malaysia)
Khadeeja Munawar (Department of Psychology, University of Wah, Wah Cantt, Pakistan) (Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences (JCSMHS), Monash University Malaysia, Bandar Sunway, Malaysia)
Bushra Akram (Department of Psychology, University of Gujrat, Gujrat, Pakistan)
Yaser Mohammed Al-Worafi (Clinical Pharmacy Department, College of Pharmacy, University of Science and Technology of Fujairah, Fujairah, United Arab Emirates)
Faizah Safina Bakrin (School of Pharmacy, KPJ Healthcare University College, Nilai, Malaysia)
Li Ying Tey (School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia)
Sabrina Anne Jacob (School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia) (Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland)
Goh Bey Hing (School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia)
Tahir Mehmood Khan (Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan)
Lee Learn Han (School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia)
Anila Kamal (National Institute of Psychology, Quaid-I-Azam University, Islamabad, Pakistan)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 3 October 2019

Issue publication date: 7 November 2019




The purpose of this paper is to provide an insight into xylophagia, its treatment, intervention options, etiological causes and possible relationship with other diseases.


A systematic search was performed across four scientific databases (i.e. Ovid Medline, Embase via Ovid, PubMed and ProQuest). All of the qualitative studies reporting on xylophagia from the inception of databases until August 2019 have been included. The quality of included studies was assessed through a ten-item checklist given by Kmet et al. (2004).


A total of 18 studies were included, and five primary themes emerged after analysis: precipitation/onset of xylophagia, co-morbid psychiatric or medical illnesses, assessment and investigation modes to confirm diagnosis, outcomes of xylophagia and treatment options comprising medical care, psychological care, counseling and duration of recovery. There were 16 females and 9 males in included studies. The mean ages and standard deviations of males and females were 29.25(12.17) years and 32.81(11.92), respectively. The mean duration and standard deviation of paper pica were 4.80(4.27) years.

Research limitations/implications

Despite the limitation that this meta-synthesis is based upon findings from case studies, results show that standardized medication regimens for treating xylophagia are still not available or are unknown. There is a dire need for further research in order to better understand the disorder. The healthcare professionals need to use reciprocal, mutually constituent influence of biological and sociocultural factors in order to screen, diagnose and manage complex psychological problems like xylophagia.


The findings advance our understanding of the positive effects of patients and family members undergoing counseling or cognitive behavior therapy in reducing stress and enhancing coping skills thus, avoiding self-damaging behaviors.



This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. All authors have no conflict of interest.


Choudhry, F.R., Munawar, K., Akram, B., Al-Worafi, Y.M., Bakrin, F.S., Tey, L.Y., Jacob, S.A., Hing, G.B., Khan, T.M., Han, L.L. and Kamal, A. (2019), "Xylophagia: a meta-synthesis of the literature", Mental Health Review Journal, Vol. 24 No. 4, pp. 275-297.



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Copyright © 2019, Emerald Publishing Limited

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