Somatic cough syndrome or psychogenic cough-what is the difference?

Abstract

The term psychogenic cough has been used to describe cough without obvious medical etiology, which is refractory to medical management and considered to have a psychiatric or psychological basis. However there are limitations in the research into psychogenic cough with limited empirical data on how to define the condition or differentially diagnose it from other forms of chronic cough. The term somatic cough syndrome was introduced by the American College of Chest physicians in 2015 during their revision of the 2006 guideline on psychogenic cough. Psychomorbidity can be present in chronic cough arising from a variety of etiologies and can impact on symptom perception and clinical management of the condition. Psychological symptoms can also improve after effective treatment of the chronic cough. The recently published American College of Chest Physicians cough guidelines recommended replacing the term psychogenic cough with the term somatic cough syndrome in order to be consistent with the Diagnostic Statistical Manual of Mental Disorders, 5^th edition (DSM-5) where the term psychogenic is no longer used. This paper outlines the current evidence regarding psychogenic cough, proposes a model for conceptualising psychological issues in chronic cough and discusses strategies for clinical management of psychological issues in patients with chronic cough.

Keywords: Cough; depression; psychophysiologic disorders.

Figure 1

Three different relationships between psychological issues and chronic cough. (A) Cough is a result of psychomorbidity; (B) psychomorbidity is the result of cough; (C) cough and psychomorbidity co-exist but have no causal relationship.