CHEST Guidelines-Somatic Cough Syndrome and Tic Cough in Adults and Children

Somatic Cough Syndrome and Tic Cough in Adults and Children

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The 2015 CHEST guideline report, updated from its 2006 predecessor, addresses somatic cough syndrome and tic cough, previously known as psychogenic cough and habit cough. The CHEST Expert Cough Panel conducted a systematic review, identifying low-quality evidence and a lack of validated criteria for diagnosing these coughs. The panel suggests redefining these phenomena to align with contemporary psychological and psychiatric understanding, as reflected in the DSM-5.<br /><br />Key recommendations include:<br />1. Avoid using nighttime cough presence or the barking character to diagnose somatic or tic cough.<br />2. Do not use depression or anxiety as diagnostic criteria for psychogenic cough in adults with persistent cough.<br />3. Diagnose tic cough when core features of tics, such as suppressibility and variability, are present.<br />4. Abandon terms "habit cough" and "psychogenic cough" in favor of "tic cough" and "somatic cough disorder," respectively.<br /><br />The guideline emphasizes non-pharmacological treatments, such as hypnosis and counseling, especially for children, acknowledging the limited evidence for using pharmacological methods.<br /><br />This guideline highlights the shift from outdated terms, underlining the importance of using updated terminology that reflects a nuanced understanding of these cough types. It acknowledges significant gaps in research, advocating for longitudinal studies, and randomized trials to develop better diagnosis and treatment protocols. The document also signifies the need for databases and registries to facilitate future research.<br /><br />In conclusion, the CHEST 2015 guideline calls for abandoning outdated terms for these cough disorders, recommending non-pharmacological management, and emphasizes aligning with DSM-5 classifications, although recognizing the evidence supporting these shifts is currently limited. The findings aim to assist clinicians, particularly those specialized in chronic cough management, in improving patient outcomes through informed and standardized care practices.

Keywords

CHEST guideline 2015

somatic cough syndrome

tic cough

psychogenic cough

habit cough

DSM-5

non-pharmacological treatments

cough diagnosis

chronic cough management

systematic review