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

ABSTRACT BACKGROUND: Several pharmacological and non-pharmacological 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% males, 96% children and adolescent). Psychogenic cough was the most common descriptive term used (90% of the studies). 95% of the patients had no cough during sleep; barking or honking quality of cough was described in only 8 studies. Hypnosis (3 studies), suggestion therapy (4 studies), and counseling and reassurance (7 studies) were the most commonly used interventions. Hypnosis was effective 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 definitions and diagnostic criteria, and the high likelihood of reporting bias. CONCLUSION: 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.

Chest. 2014 May 15. doi: 10.1378/chest.14-0795. Haydour Q, Alahdab F, Farah M, Moreno PB, Vertigan AE, Newcombe PA, Pringsheim T, Chang AB, Rubin BK, McGarvey L, Weir KA, Altman KW, Feinstein A, Murad M, Irwin RS.