Management and Diagnosis of Psychogenic Cough, Habit Cough, and Tic Cough: A Systematic Review

Qusay Haydour, Fares Alahdab, Magdoleen Farah, Patricia Barrionuevo Moreno, Anne Vertigan, Peter Newcombe, Tamara Pringsheim, Anne Chang, Bruce Rubin, Lorcan McGarvey, Kelly Weir, Kenneth Altman, Anthony Feinstein, Mohammad Murad, Richard Irwin

    Research output: Contribution to journalArticle

    Abstract

    Background: Several pharmacologic and nonpharmacologic therapeutic options have been used to treat cough that is not associated with a pulmonary or extrapulmonary etiology.

    Methods:
    We conducted a systematic review to summarize the evidence supporting different cough management options in adults and children with psychogenic, tic, and habit cough. Medline, EMBASE, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus were searched from the earliest inception of each database to September 2013. Content experts were contacted, and we searched bibliographies of included studies to identify additional references.

    Results: A total of 18 uncontrolled studies were identified, enrolling 223 patients (46% male subjects, 96% children and adolescents). Psychogenic cough was the most common descriptive term used (90% of the studies). Most of the patients (95%) had no cough during sleep; barking or honking quality of cough was described in only eight studies. Hypnosis (three studies), suggestion therapy (four studies), and counseling and reassurance (seven studies) were the most commonly used interventions. Hypnosis was eff ective in resolving cough in 78% of the patients and improving it in another 5%. Suggestion therapy resolved cough successfully in 96% of the patients. The greatest majority of improvements noted with these forms of therapy occurred in the pediatric age group. The quality of evidence is low due to the lack of control groups, the retrospective nature of all the studies, heterogeneity of defi nitions and diagnostic criteria, and the high likelihood of reporting bias.

    Conclusions:
    Only low-quality evidence exists to support a particular strategy to define and treat psychogenic, habit, and tic cough. Patient values, preferences, and availability of potential therapies should guide treatment choice.
    Original languageEnglish
    Pages (from-to)355-372
    Number of pages18
    JournalChest
    Volume146
    Issue number2
    DOIs
    Publication statusPublished - Aug 2014

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