The interrelationship of chronic cough and depression: a prospective population-based study

Abstract

BackgroundChronic cough is a debilitating medical condition that is often complicated by psychomorbidities such as depressive symptoms. Nevertheless, little is known about the impact of chronic cough on the risk of developing depression. Therefore, we investigated the association between chronic cough and prevalent, incident, as well as recurrent depression in a population-based sample of middle-aged and older persons.MethodsWithin the Rotterdam Study, a population-based cohort, we defined chronic cough as reporting daily coughing for at least 3 months. Depression was assessed using the Center for Epidemiologic Studies–Depression scale, clinical interviews, and medical records. Associations between chronic cough and depression were determined with linear, logistic and Cox regression analyses.ResultsThe study included 5877 participants (mean age±standard deviation: 72±8 years, 59% female) who contributed 37 287 person-years of follow-up. At baseline, participants with chronic cough reported more depressive symptoms (adjusted standardised mean difference 0.15, 95% CI 0.07–0.22) compared to those without chronic cough. Over time, chronic cough was associated with an increased risk of depression in participants with a history of depression (HR 1.45, 95% CI 1.13–1.84) but not in those without a history of depression (HR 0.91, 95% CI 0.68–1.22).ConclusionsAdults with chronic cough have a disproportionate burden of depressive symptoms and an increased risk of recurrent depression. This highlights the importance of screening for depression in patients with chronic cough.

Altered functional connectivity of the nucleus tractus solitarii in patients with chronic cough after lung surgery: an rs‐fMRI study

“…Furthermore, the ACC is also involved in the cognitive and emotional processing of perceptual signals, 28 and structural changes in this region may negatively affect aspects of cough emotional processing and perceived cough severity in patients with chronic cough after lung surgery, 27,28 which is consistent with our findings. Our study found higher HAMA anxiety scores in patients with lower NTS‐ACC functional connectivity, suggesting that activating the ACC may reduce anxiety symptoms in chronic cough patients.…”

“…27 Meanwhile, our results showed a significant positive correlation between the FC values of the NTS-ACC and LCQ-MC scores and a negative correlation with the VAS, which we speculate may be due to plastic changes in the ACC as a result of chronic cough after lung surgery, with a decrease in its own function and weakened functional connectivity with other nuclei, resulting in the loss of cough suppression and leading to the generation of cough hypersensitivity responses. 27 Furthermore, the ACC is also involved in the cognitive and emotional processing of perceptual signals, 28 and structural changes in this region may negatively affect aspects of cough emotional processing and perceived cough severity in patients with chronic cough after lung surgery, 27,28 which is consistent with our findings. Our study found higher HAMA anxiety scores in patients with lower NTS-ACC functional connectivity, suggesting that activating the ACC may reduce anxiety symptoms in chronic cough patients.…”

Worldwide prevalence, risk factors and burden of chronic cough in the general population: a narrative review

“…Fatigue, disturbed sleep, anger, frustration, anxiety, and depression were also commonly reported concomitant symptoms or comorbidities in patients with chronic cough ( 21 , 73 , 74 ). In addition, urinary incontinence was a commonly reported concomitant symptom in women with an occurrence of 55% ( 73 ).…”

The burden and impact of chronic cough in severe disease

“…Chronic cough in the general population may have a significant psychological and social impact, as patients may fear public places, avoid meetings, and so forth, and cause other symptoms such as voice disturbances [13]. Individuals with chronic cough also have more frequent episodes of recurrent depression, chronic pain, and comorbidities, in general [3,12,14]. In patients with severe diseases, cough can also increase fatigue and cause anxiety [15][16][17].…”