A habit cough is a
chronic cough
Chronic cough is long-term coughing, sometimes defined as more than several weeks or months. The term can be used to describe the different causes related to coughing, the three main ones being upper airway cough syndrome, asthma and gastroesopha ...
that has no underlying organic cause or medical diagnosis,
and does not respond to conventional medical treatment.
This is sometimes called tic cough, somatic cough syndrome and previously psychogenic cough, but without clinical justification.
[
Different terms and conditions involving this form of chronic cough were ill-defined and not well distinguished.]
Coughing may develop in children or adolescents after a cold
Cold is the presence of low temperature, especially in the atmosphere. In common usage, cold is often a subjective perception. A lower bound to temperature is absolute zero, defined as 0.00K on the Kelvin scale, an absolute thermodynamic ...
or other airway irritant. Similar symptoms of habit cough have been less frequently reported in adults but may of may not 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, de-scribed, “...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 .....” This was insightful reasoning on the part of Dr. Creighton.
In the 19th century, habit cough was also referred to as stomach cough.
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.[ A psychological or psychiatric basis has been considered but not established.]
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 tic
A tic is a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups.American Psychiatric Association (2000)DSM-IV-TR: Tourette's Disorder.''Diagnostic and Statistical Manual of Mental Disorders'', 4th ed., ...
s and tic disorder
Tic disorders are defined in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, nonrhythmic movements). Tic disorders are defined similarly by the World Health ...
s.
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."[
]
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
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an disease, illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormali ...
such as fever
Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single ...
. 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. Habit Cough is usually readily identified by its clinical presentation as a reptitive 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
Hypnosis is a human condition involving focused attention (the selective attention/selective inattention hypothesis, SASI), reduced peripheral awareness, and an enhanced capacity to respond to suggestion.In 2015, the American Psychologica ...
has also been effective and may be particularly helpful when suggestion therapy is not effective.(10)
References
{{reflist9. 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.
Cough