Habit cough

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A habit cough is a chronic cough that has no underlying organic cause or medical diagnosis, [1] [2] and does not respond to conventional medical treatment. [3] This is sometimes called tic cough,somatic cough syndrome and previously psychogenic cough, but without clinical justification. [1]

Contents

Different terms and conditions involving this form of chronic cough were ill-defined and not well distinguished. [4]

Coughing may develop in children or adults after a cold or other airway irritant. [5] Similar symptoms of habit cough have been reported in adults and may be the same disorder as is seen in children or adolescents.

Classification and name

History

A medical textbook from 1685 by Thomas Willis, (1621-1675) described an adult woman with “a violent dry cough following her day and night, unless she was fallen asleep,” a description that would fit the habit cough diagnosis today. A 1694 medical book by Franciscus Mercurios (1614-1699), a Flemish physician, alchemist, kabbalist, and writer included in his book, The Spirit of Diseases: “...Habitual Cough, which often continues after the first cough, which was caused by the cold, is gone .... and the Habitual Cough often proceed.” Charles Creighton (1847–1927), a British physician and medical author, in an 1886 medical book, Illustrations of Unconscious Memory in Disease, described, "...a habit cough – a reflex effect persisting after the cause is gone .... or an acquired habit....” He went on to state, “...the treatment of it is to break the habit ....."

In the 19th century, habit cough was also referred to as "stomach cough". [6]

In the 20th century, the terms habit cough, tic cough, psychogenic cough, somatic cough syndrome and somatic cough disorder have been used to describe a type of chronic cough in the absence of an identifiable medical disease that does not respond to conventional treatment. [1] A psychological or psychiatric basis has been considered but not established. [7]

Habit or tic cough

The ACCP suggested in 2015 that the name tic cough replace habit cough without any factual or clinical basis, even though there were no clinically apparent shared characteristics with tics and tic disorders.

Weinberger and Lockshin wrote in 2017: "However, our experience has found habit cough to fit the syndrome best, and has been most acceptable to the families in diagnosing and explaining the nature of the disorder." [2]

Symptoms

Habit cough is commonly characterized by a harsh barking cough, and can persist for weeks, months, and even years. The cough's hallmarks are severe frequency, sometimes a cough every 2–3 seconds, and the lack of other symptoms such as fever. The patient can have trouble falling asleep but once asleep will not cough. Absence once asleep is considered essential.

There are many causes of chronic cough. [8] Habit cough is usually readily identified by its clinical presentation as a repetitive daily non-productive (dry) cough that is absent during sleep. People feel that the cough is different from ordinary coughs. The cough can vary in intensity, pattern, and frequency. The clinical characteristics bear little resemblance to other causes of cough. A chest x-ray and pulmonary function if the child can perform the test are generally sufficient to provide evidence for the absence of lung disease causing the cough.

Treatment

Suggestion therapy was established in the 1966 publication of Bernard Berman, an allergist in Boston. He cured 6 children by "the art of suggestion" for which he suggested that the physician must have sound judgment, be aware of the patient's emotional makeup, be honest and forthright with the patient, establish rapport with the patient and parents, and understand the art of suggestion. [9]

Understanding and experience in the art of suggestion

Treatment has relied on suggesting to the patient that they can break the coughing habit themselves. This has been done by direct contact with the patient, by video conference, and by proxy where a video of suggestion therapy stopping cough is observed. Hypnosis has also been effective and may be particularly helpful when suggestion therapy is not effective. [10]

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Chronic cough is long-term coughing, sometimes defined as more than several weeks or months. Generally a cough lasting for more than eight weeks for an adult would meet the clinical definition of a chronic cough; and for children this threshold is lower. The term can be used to describe the different causes related to coughing, the three main ones being upper airway cough syndrome, asthma and gastroesophageal reflux disease. It occurs in the upper airway of the respiratory system. Generally, a cough lasts around one to two weeks; however, chronic cough can persist for an extended period of time defined as six weeks or longer. People with chronic cough often experience more than one cause present. Due to the nature of the syndrome, the treatments used are similar; however, there are a subsequent number of treatments available, and the clinical management of the patients remains a challenge. Risk factors include exposure to cigarette smoke, and exposure to pollution, especially particulates.

References

  1. 1 2 3 Vertigan AE, Murad MH, Pringsheim T, et al. (July 2015). "Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children: CHEST Guideline and Expert Panel Report". Chest (Review). 148 (1): 24–31. doi:10.1378/chest.15-0423. PMC   4493876 . PMID   25856777.
  2. 1 2 Weinberger M, Lockshin B (March 2017). "When is cough functional, and how should it be treated?". Breathe (Review). 13 (1): 22–30. doi:10.1183/20734735.015216. PMC   5344044 . PMID   28289448.
  3. ↑ Wilkes J (March 2016). "ACCP Provides Updated Recommendations on the Management of Somatic Cough Syndrome and Tic Cough". Am Fam Physician (Review). 93 (5): 416. PMID   26926981.
  4. ↑ Haydour Q, Alahdab F, Farah M, et al. (August 2014). "Management and diagnosis of psychogenic cough, habit cough, and tic cough: a systematic review". Chest (Review). 146 (2): 355–372. doi:10.1378/chest.14-0795. PMID   24833061.
  5. ↑ Goldsobel AB, Chipps BE (March 2010). "Cough in the pediatric population". J. Pediatr. (Review). 156 (3): 352–358.e1. doi:10.1016/j.jpeds.2009.12.004. PMID   20176183.
  6. ↑ Creighton C (1886). Illustrations of Unconscious Memory in Disease. London: H. K. Lewis. pp.  60–65.
  7. ↑ Irwin RS, Glomb WB, Chang AB (January 2006). "Habit cough, tic cough, and psychogenic cough in adult and pediatric populations: ACCP evidence-based clinical practice guidelines". Chest (Review). 129 (1 Suppl): 174S–179S. doi: 10.1378/chest.129.1_suppl.174S . PMID   16428707.
  8. ↑ Weinberger M, Fischer A (2014). "Differential diagnosis of chronic cough in children". Allergy Asthma Proc (Review). 35 (2): 95–103. doi:10.2500/aap.2014.35.3711. PMID   24717785.
  9. ↑ Berman BA. Habit cough in adoescent children. Ann Allergy 1966;24:43-46.
  10. ↑ Anbar RD, Hall Hr. Childhood habit cough treated with self-hypnosis. J Pediatr 2004;144:213-217.

Weinberger M, Buettner D, Anbar RD. A Review, Update, and Commentary for the Cough without a Cause: Facts and Factoids of the Habit Cough. J. Clin. Med. 2023, 12, 1970. https://doi.org/10.3390/jcm12051970

Weinberger M, Buettner D. Habit Cough is a Cause of Chronic Cough in Adults. Ann Allergy Asthma Immunol 2023;130(6):808-809

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