Habit cough

A habit cough (also known inappropriately as psychogenic cough, tic cough, and somatic cough disorder) is a cough that may develop in children or adolescents after a cold or other airway irritant.[1] Similar symptoms have been less frequently reported in adults but may not be the same disorder as is seen in children or adolescents. First described in 1966 in a small series treated by "the art of suggestion,"[2] further publications identified patients with the same symptoms treated effectively with suggestion therapy.[3][4][5][6][7] The average age has been reported as 10 years at clinics in Iowa, Minnesota, and London England.[7] Eighty-five percent of 120 children diagnosed with habit cough over 20 years in Iowa were between ages 8 and 14 with a range from 5 to 18.[5] Based on experience in Iowa and London, major referral centers for children may be expected to encounter at least 7-9 per year.

Symptoms

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

Diagnosis

While there are many causes of chronic cough,[8] it is generally not essential for an extensive evaluation of multiple causes of cough to be made since the clinical pattern is usually sufficiently apparent that the diagnosis can be made by the clinical presentation, i.e., a repetitive harsh barking cough that is absent once asleep. Those familiar with this disorder readily recognize it without much in the way of testing.

Treatment

Successful treatments have involved a few reports utilizing hypnosis, but suggestion therapy has been most extensively used.

References
  1. Goldsobel AB, Chipps BE (March 2010). "Cough in the pediatric population". J. Pediatr. 156 (3): 352–358.e1. doi:10.1016/j.jpeds.2009.12.004. PMID 20176183.
  2. Berman, B. A. (January 1966). "Habit cough in adolescent children". Annals of Allergy. 24 (1): 43–46. ISSN 0003-4738. PMID 5902120.
  3. Lokshin, B.; Lindgren, S.; Weinberger, M.; Koviach, J. (Dec 1991). "Outcome of habit cough in children treated with a brief session of suggestion therapy". Annals of Allergy. 67 (6): 579–582. ISSN 0003-4738. PMID 1750719.
  4. Weinberger M.  The habit cough syndrome and its variations. Lung  2012;190:45-53.
  5. Weinberger M, Hoegger M.  The Cough without a Cause: The Habit Cough Syndrome.  J Allergy Clin Immunol 2016;137:930-931.
  6. Weinberger M, Lockshin B. When is cough functional, and what to do? Breathe (Sheff). 2017;13:22–30.
  7. Weinberger M. The Habit Cough: Diagnosis and treatment. Pediatric Pulmonology. 2018;53:535–537.
  8. Weinberger M, Fischer A.  Differential diagnosis of chronic cough in children.  Asthma and Allergy Proceedings 2014;35:95-103.
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