We at Hyfe, Inc., are a company devoted to working on tools to better understand the importance of cough. It is Hyfe’s intention in the future to seek regulatory approval for medical products that analyze cough in order that they may be used to diagnose, monitor, and facilitate better treatment of respiratory illnesses.
Each person's experience with coughing is unique. The habit cough1 is a debilitating disorder that is challenging to diagnose and treat in everyday clinical visits. It impairs your quality of life even though, as you will come to learn below, it does not have a physical cause. Habit coughs are usually seen in children and teenagers, but even adults can develop them.
In this article, we will find out what the habit cough is, its symptoms and potential causes, and its diagnosis and treatment.
A habit cough is a recurrent cough that happens without any underlying physical condition. Other names that have been used to refer to this potential cause of chronic cough in research include2:
However, in 2015, the American College of Chest Physicians (ACCP) recommended that the name Somatic Cough Syndrome and tic cough replace the terms psychogenic and habit cough respectively, so as to be aligned with the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) terminology.3
While there is no physical abnormality that causes this symptom, in some cases upper respiratory tract infections trigger the habit cough4, but once the infection resolves, the cough remains out of habit. Such a cough can persists for weeks, months, or even years, which can then be categorized as a chronic cough (lasting more than four weeks).
Psychosocial stressors have also been linked to habit coughing5. This occurs in such a way that the individual exhibits a conversion disorder. This is a psychiatric disorder in which one may use a physical symptom – such as cough – to divert attention and feelings away from disruptive stressors. These stressors, much like other medical symptoms like headaches and stomachaches, can make the habit cough worse. In adults, such stressors can include:
In children such stressors can include:
Additionally, in some children researchers linked habit cough to psychiatric disorders such as tic disorders and Tourette syndrome.
The typical presentation of a habit cough is6:
Psychogenic cough is diagnosed by excluding other causes.
Therefore, your doctor can identify habit cough by confirming the presence of the aforementioned symptoms and ruling out any underlying medical disorders that may be the culprit. This calls for an examination of the body and potentially doing various diagnostic tests such as:
Your physician can suggest that you seek additional evaluation and care from a pediatrician if the patient is a child.
Habit cough typically does not respond to medication because there is no e.g., infection to treat. Consequently, it should come as no surprise that treatment with antibiotics and antitussives will be ineffective.
For this reason, it is crucial to take habit cough into account when making a diagnosis of chronic cough, particularly in people who don't respond to standard treatment for other, more prevalent causes of cough, such as asthma, GERD, and postnasal drip, among others.
Therapy and hypnosis treatment have been shown to be effective12. There are many suggestion/behavioral therapy techniques, in which patients are told repeatedly that they can control the cough, that have successfully reduced cough.
Hypnosis can help children ignore the urge to cough by teaching them how to relax, picture controlling their cough with a dial, or determine whether a stressful situation may be prolonging their cough and how to deal with it more effectively. Half of the time and for the majority of patients, hypnosis can cure habit cough with just one session15.
A brief example of how this hypnotic suggestion could be done is for a child telling them that their cough has been in charge of their lives and the lives of their caregivers and that it is now time to regain control. After that, ask the child to keep score: if they can control their coughing, they gain a point; if not, the cough receives the point.
These techniques can be applied in many different ways, but all require a bond and level of trust with the medical practitioner.
In a nutshell, understanding what a habit cough is and being reassured that nothing else is wrong are the first steps in managing a habit cough. Additionally, correctly diagnosing and treating habit cough can help avoid unnecessary interventions and complications from medical interventions, for instance, the adverse effects from corticosteroids.
While patients may not be concerned about their symptoms, the symptoms are bothersome to others, such as family members, health care professionals, and educational staff. For this reason, habit cough is a condition to look out for because it may disturb other family members’ sleep and can be disruptive for teachers and peers. Additionally, it can be a sign of hidden psychological distress in the cougher.References