Somatic cough syndrome or psychogenic cough—what is the difference?

Vertigan, Anne E.

doi:10.21037/jtd.2017.03.119

Cited by 27 publications

(31 citation statements)

References 40 publications

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“…Psychomorbidity is present in all patients with chronic cough with a variety of aetiologies, and tends to decrease following successful treatment [73]. There are limited criteria for the diagnosis of psychogenic (or somatic) cough and features of psychogenic cough reported in the literature are not unique to psychogenic cough [72].…”

Section: Chronic Cough In Childrenmentioning

confidence: 99%

ERS guidelines on the diagnosis and treatment of chronic cough in adults and children

et al. 2019

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These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity has allowed an umbrella term that explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach. Thus, adults with chronic cough now have a firm physical explanation for their symptoms based on vagal afferent hypersensitivity. Different treatable traits exist with cough variant asthma (CVA)/eosinophilic bronchitis responding to anti-inflammatory treatment and non-acid reflux being treated with promotility agents rather the anti-acid drugs. An alternative antitussive strategy is to reduce hypersensitivity by neuromodulation. Low-dose morphine is highly effective in a subset of patients with cough resistant to other treatments. Gabapentin and pregabalin are also advocated, but in clinical experience they are limited by adverse events. Perhaps the most promising future developments in pharmacotherapy are drugs which tackle neuronal hypersensitivity by blocking excitability of afferent nerves by inhibiting targets such as the ATP receptor (P2X3). Finally, cough suppression therapy when performed by competent practitioners can be highly effective. Children are not small adults and a pursuit of an underlying cause for cough is advocated. Thus, in toddlers, inhalation of a foreign body is common. Persistent bacterial bronchitis is a common and previously unrecognised cause of wet cough in children. Antibiotics (drug, dose and duration need to be determined) can be curative. A paediatric-specific algorithm should be used.

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Section: Chronic Cough In Childrenmentioning

confidence: 99%

ERS guidelines on the diagnosis and treatment of chronic cough in adults and children

et al. 2019

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“…5 According to the literature on psychomorbidity among children with chronic cough, anxiety, and depression may be seen either as a result of the chronic cough 13,14 or may exacerbate the symptoms. 4,15 Interestingly, ADHD was the most prevalent disorder in the PFBD group, followed by tic disorders and specific phobias. Therefore, our results showed that there is an increased risk of psychomorbidity in children with PFBD, but the relationship is complex and not pointing to a specific disorder.…”

Section: Discussionmentioning

confidence: 98%

“…According to the literature on psychomorbidity among children with chronic cough, anxiety, and depression may be seen either as a result of the chronic cough or may exacerbate the symptoms . Interestingly, ADHD was the most prevalent disorder in the PFBD group, followed by tic disorders and specific phobias.…”

Section: Discussionmentioning

confidence: 99%

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Psychiatric comorbidity in children with psychogenic and functional breathing disorders

Örengül

Ertaş

Kahraman

et al. 2019

Pediatric Pulmonology

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Background The present study aims to assess psychiatric diagnoses in children with psychogenic and functional breathing disorders (PFBD), which consist of children with psychogenic cough, throat‐clearing tics, and sighing dyspnea, and compare them to a control group without any diagnosis of chronic medical problems. Methods The participants consist of 52 children with PFBD and 42 children without any chronic medical problems. Psychiatric diagnoses were assessed via semistructured psychiatric interviews in both groups. Results The two groups did not differ on age (PFBD group 11.25 ± 2.61, control group 11.17 ± 2.58; t = 0.14, P = .88) or sex (48.1% of the PFBD group were female, 61.9% of the control group were female; χ2 = 1.79, P = .18). 55.8% of the PFBD group and 28.6% of the control group had at least one psychiatric diagnosis according to the semistructured interviews (χ2 = 6.99, P = .008). The most common psychiatric diagnoses in the PFBD group were attention deficit hyperactivity disorder (ADHD; 17.3%), tic disorders, (15.4%), and specific phobia (15.4%). 11.5% of the cases in the PFBD group were diagnosed with somatic symptom disorder and more than half of the patients (n = 27 (51.9%)) showed clinical characteristics of tic disorders. Conclusion Psychiatric diagnoses are common in children with PFBD, and teamwork involving child psychiatrists may be essential for the management of children with PFBD.

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“… 73 The diagnosis of somatic cough syndrome requires the absence of alternative diagnosis after investigation of other diagnoses and the patient meets the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a somatic symptom disorder. 74 These DSM-5 criteria include one or more somatic symptoms that are distressing or result in significant disruption to daily life, such as disproportionate and persistent thoughts about the seriousness of the symptoms, high levels of anxiety about symptoms or excessive time and energy devoted to the symptoms. 74 In patients with refractory unexplained chronic cough, American College of Chest Physicians (ACCP) recommendations indicate that the diagnosis of tic cough can be made when the patient presents the core clinical features of tics including suppressibility, distractibility, suggestibility, variability, and the presence of a premonitory sensation whether the cough is single or one of many tics.…”

Section: Other Causes To Considermentioning

confidence: 99%

Managing patients with chronic cough: challenges and solutions

Perotin-Collard¹,

Claire²,

Dewolf³

et al. 2018

TCRM

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Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic cough. Different steps are detailed, including the initial research of an obvious etiology and alert signs that should lead to further investigation of underlying condition. The diagnosis of the most frequent causes: asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airway cough syndrome should be considered, assessed and treated accordingly. Recent advances have been made in the comprehension of refractory chronic cough pathophysiology as well as its pharmacologic and non-pharmacologic treatment, especially speech pathology therapy.

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Somatic cough syndrome or psychogenic cough—what is the difference?

Cited by 27 publications

References 40 publications

ERS guidelines on the diagnosis and treatment of chronic cough in adults and children

ERS guidelines on the diagnosis and treatment of chronic cough in adults and children

Psychiatric comorbidity in children with psychogenic and functional breathing disorders

Managing patients with chronic cough: challenges and solutions

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