Cognitive Behavior Therapy for Psychogenic Cough in Children : a case series

Introduction: Cough is the most common presenting symptom in pediatric primary care settings. Coughcan impact a child's activity level and ability to sleep, play or attend school and is often a source ofparental anxiety. However, an etiology of cough is not always easily identified even after a thoroughsystematic investigation and psychological and neurological conditions are in the differential diagnosis.Psychogenic cough is diagnosed in cases without a clear pulmonary or extrapulmonary etiology in thepresence of some suggestive clinical characteristics and/or an association with psychological issue.Psychogenic cough has been reported to be the second most common cause of chronic cough in children ofage 6-16 years.Methodology: The present paper highlights four case reports of children who presented with symptoms ofpsychogenic cough in the OPD of CNBC hospital, Delhi.The presenting nature of the symptoms alongwith the underlying psychological factors have been discussed. Cognitive Behavioural techniques likedistraction and cognitive restructuring interventions with the children along with family interventions wereused.Conclusions: All the children showed significant improvement at the end of therapy. Three month followup showed that the results were maintained. Cognitive Behavioural approaches are found to be effective inmanaging psychogenic cough and the present paper highlights the process of cognitive behaviouralmanagement of psychogenic cough in children.Key words: cognitive behavior therapy, cough,

A Case of Psychogenic Cough / 소아알레르기및호흡기학회지

Chronic cough-defined as a cough that persists for more than 3 weeks-is one of the most common symptoms during childhood that requires evaluation of causes and appropriate management, because it can be very disturbing to daily activities at home and school. Besides asthma, postnasal drip syndrome, post infectious cough, chronic bronchitis, gastroesophageal reflux disease and congenital anomaly, psychogenic factors are known to be possible causes of chronic cough in children. "Habit cough" and "respiratory tic" are different names given to psychogenic coughs. Psychogenic cough is croupy, loud, and unresponsive to antitussives or bronchodilators. It becomes more noticeable to attention and disappears during sleep. Over 90% of cases of psychogenic cough have been reported in patients under 18 years of age and its diagnosis is often delayed due to the time consumed for exclusion of other underlying organic disorders and the recognition of psychogenic factors as an etiology. We report on the case of an 11-year-old boy who presented with chronic cough of a barking nature and was diagnosed as having psychogenic cough by characteristics and 24-hour monitoring of cough frequency and who was treated by psychological interview.