The cough and the bedsheet
Of 33 patients with psychogenic cough tic, 31 were successfully treated using an unusual reinforced suggestion technique. The cough usually follows an incidental upper respiratory tract infection and persists as a loud paroxysmal barking or honking sound for weeks to months. Paroxysms occur all day...
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Veröffentlicht in: | Pediatrics (Evanston) 1984-07, Vol.74 (1), p.11-15 |
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description | Of 33 patients with psychogenic cough tic, 31 were successfully treated using an unusual reinforced suggestion technique. The cough usually follows an incidental upper respiratory tract infection and persists as a loud paroxysmal barking or honking sound for weeks to months. Paroxysms occur all day but cease with sleep. The diagnosis is often delayed for weeks to months while the patient is exposed to an increasing intensity of diagnostic procedures and therapy. Thirty percent of some 20 patients previously reported in the literature had been hospitalized. The reinforced suggestion technique depends upon the physician's convincing the patient that the persistent cough has weakened the chest muscles, which are now unable to contain the cough, and that a bedsheet tightly wrapped around the chest will provide the necessary support to stop the cough within 24 to 48 hours. The typical patient can produce the cough on command, has an ambivalent response to the prospect of care, is unconcerned about his symptoms, submits willingly to the examination and procedures, and is kept out of school for the duration of the cough. Findings on physical examination are normal except for abnormal gag and corneal reflexes. The gag reflex was depressed in six and absent in 20 of the 31 patients. The corneal reflex was depressed in 16 and absent in 5 of the 31 patients. These abnormal responses help to corroborate the psychogenic etiology. Early recognition of the nonorganic nature of this syndrome will reduce parental anxiety, loss of school time, risk of iatrogenic complications, and unnecessary medical and hospital expense. |
doi_str_mv | 10.1542/peds.74.1.11 |
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Q ; STONE, S. M</creator><creatorcontrib>COHLAN, S. Q ; STONE, S. M</creatorcontrib><description>Of 33 patients with psychogenic cough tic, 31 were successfully treated using an unusual reinforced suggestion technique. The cough usually follows an incidental upper respiratory tract infection and persists as a loud paroxysmal barking or honking sound for weeks to months. Paroxysms occur all day but cease with sleep. The diagnosis is often delayed for weeks to months while the patient is exposed to an increasing intensity of diagnostic procedures and therapy. Thirty percent of some 20 patients previously reported in the literature had been hospitalized. The reinforced suggestion technique depends upon the physician's convincing the patient that the persistent cough has weakened the chest muscles, which are now unable to contain the cough, and that a bedsheet tightly wrapped around the chest will provide the necessary support to stop the cough within 24 to 48 hours. The typical patient can produce the cough on command, has an ambivalent response to the prospect of care, is unconcerned about his symptoms, submits willingly to the examination and procedures, and is kept out of school for the duration of the cough. Findings on physical examination are normal except for abnormal gag and corneal reflexes. The gag reflex was depressed in six and absent in 20 of the 31 patients. The corneal reflex was depressed in 16 and absent in 5 of the 31 patients. These abnormal responses help to corroborate the psychogenic etiology. Early recognition of the nonorganic nature of this syndrome will reduce parental anxiety, loss of school time, risk of iatrogenic complications, and unnecessary medical and hospital expense.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.74.1.11</identifier><identifier>PMID: 6739203</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>Elk Grove Village, IL: American Academy of Pediatrics</publisher><subject>Adaptation, Psychological ; Adolescent ; Bedding and Linens ; Biological and medical sciences ; Blinking ; Child ; Child, Preschool ; Cough - psychology ; Cough - therapy ; Female ; Gagging ; Humans ; Infant ; Male ; Medical sciences ; Miscellaneous ; Physician-Patient Relations ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychophysiologic Disorders - therapy ; Reinforcement (Psychology) ; Respiratory Tract Infections - complications ; Suggestion ; Syndrome ; Tic Disorders - psychology ; Time Factors ; Treatments</subject><ispartof>Pediatrics (Evanston), 1984-07, Vol.74 (1), p.11-15</ispartof><rights>1985 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c315t-f27672e9792d4d6af03ef6ebc7b3d100f2b0bfa25ed1bae1a6a9c97ec00cd0893</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8971501$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/6739203$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>COHLAN, S. Q</creatorcontrib><creatorcontrib>STONE, S. M</creatorcontrib><title>The cough and the bedsheet</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Of 33 patients with psychogenic cough tic, 31 were successfully treated using an unusual reinforced suggestion technique. The cough usually follows an incidental upper respiratory tract infection and persists as a loud paroxysmal barking or honking sound for weeks to months. Paroxysms occur all day but cease with sleep. The diagnosis is often delayed for weeks to months while the patient is exposed to an increasing intensity of diagnostic procedures and therapy. Thirty percent of some 20 patients previously reported in the literature had been hospitalized. The reinforced suggestion technique depends upon the physician's convincing the patient that the persistent cough has weakened the chest muscles, which are now unable to contain the cough, and that a bedsheet tightly wrapped around the chest will provide the necessary support to stop the cough within 24 to 48 hours. The typical patient can produce the cough on command, has an ambivalent response to the prospect of care, is unconcerned about his symptoms, submits willingly to the examination and procedures, and is kept out of school for the duration of the cough. Findings on physical examination are normal except for abnormal gag and corneal reflexes. The gag reflex was depressed in six and absent in 20 of the 31 patients. The corneal reflex was depressed in 16 and absent in 5 of the 31 patients. These abnormal responses help to corroborate the psychogenic etiology. Early recognition of the nonorganic nature of this syndrome will reduce parental anxiety, loss of school time, risk of iatrogenic complications, and unnecessary medical and hospital expense.</description><subject>Adaptation, Psychological</subject><subject>Adolescent</subject><subject>Bedding and Linens</subject><subject>Biological and medical sciences</subject><subject>Blinking</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cough - psychology</subject><subject>Cough - therapy</subject><subject>Female</subject><subject>Gagging</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Physician-Patient Relations</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychophysiologic Disorders - therapy</subject><subject>Reinforcement (Psychology)</subject><subject>Respiratory Tract Infections - complications</subject><subject>Suggestion</subject><subject>Syndrome</subject><subject>Tic Disorders - psychology</subject><subject>Time Factors</subject><subject>Treatments</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1984</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1Lw0AQhhdRaq3ePAlCD-LJxJndbDZ7lOIXFLzU87Ifs7aSNjWbHPz3Rhp6Gob3mQfmZewaIUdZ8Mc9hZSrIscc8YRNEXSVFVzJUzYFEJgVAPKcXaT0DQCFVHzCJqUSmoOYspvVmua-6b_Wc7sL827Y3OBbE3WX7CzaOtHVOGfs8-V5tXjLlh-v74unZeYFyi6LXJWKk1aahyKUNoKgWJLzyomAAJE7cNFySQGdJbSl1V4r8gA-QKXFjN0fvPu2-ekpdWa7SZ7q2u6o6ZOpEEVZKjmADwfQt01KLUWzbzdb2_4aBPNfhfmvwqjCoBluZux29PZuS-EIj78P-d2Y2-RtHVu785t0xCqtUAKKP-0eZVs</recordid><startdate>198407</startdate><enddate>198407</enddate><creator>COHLAN, S. Q</creator><creator>STONE, S. M</creator><general>American Academy of Pediatrics</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>198407</creationdate><title>The cough and the bedsheet</title><author>COHLAN, S. Q ; STONE, S. M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c315t-f27672e9792d4d6af03ef6ebc7b3d100f2b0bfa25ed1bae1a6a9c97ec00cd0893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1984</creationdate><topic>Adaptation, Psychological</topic><topic>Adolescent</topic><topic>Bedding and Linens</topic><topic>Biological and medical sciences</topic><topic>Blinking</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cough - psychology</topic><topic>Cough - therapy</topic><topic>Female</topic><topic>Gagging</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Physician-Patient Relations</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychophysiologic Disorders - therapy</topic><topic>Reinforcement (Psychology)</topic><topic>Respiratory Tract Infections - complications</topic><topic>Suggestion</topic><topic>Syndrome</topic><topic>Tic Disorders - psychology</topic><topic>Time Factors</topic><topic>Treatments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>COHLAN, S. Q</creatorcontrib><creatorcontrib>STONE, S. M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>COHLAN, S. Q</au><au>STONE, S. M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The cough and the bedsheet</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>1984-07</date><risdate>1984</risdate><volume>74</volume><issue>1</issue><spage>11</spage><epage>15</epage><pages>11-15</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Of 33 patients with psychogenic cough tic, 31 were successfully treated using an unusual reinforced suggestion technique. The cough usually follows an incidental upper respiratory tract infection and persists as a loud paroxysmal barking or honking sound for weeks to months. Paroxysms occur all day but cease with sleep. The diagnosis is often delayed for weeks to months while the patient is exposed to an increasing intensity of diagnostic procedures and therapy. Thirty percent of some 20 patients previously reported in the literature had been hospitalized. The reinforced suggestion technique depends upon the physician's convincing the patient that the persistent cough has weakened the chest muscles, which are now unable to contain the cough, and that a bedsheet tightly wrapped around the chest will provide the necessary support to stop the cough within 24 to 48 hours. The typical patient can produce the cough on command, has an ambivalent response to the prospect of care, is unconcerned about his symptoms, submits willingly to the examination and procedures, and is kept out of school for the duration of the cough. Findings on physical examination are normal except for abnormal gag and corneal reflexes. The gag reflex was depressed in six and absent in 20 of the 31 patients. The corneal reflex was depressed in 16 and absent in 5 of the 31 patients. These abnormal responses help to corroborate the psychogenic etiology. Early recognition of the nonorganic nature of this syndrome will reduce parental anxiety, loss of school time, risk of iatrogenic complications, and unnecessary medical and hospital expense.</abstract><cop>Elk Grove Village, IL</cop><pub>American Academy of Pediatrics</pub><pmid>6739203</pmid><doi>10.1542/peds.74.1.11</doi><tpages>5</tpages></addata></record> |
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source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
subjects | Adaptation, Psychological Adolescent Bedding and Linens Biological and medical sciences Blinking Child Child, Preschool Cough - psychology Cough - therapy Female Gagging Humans Infant Male Medical sciences Miscellaneous Physician-Patient Relations Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychophysiologic Disorders - therapy Reinforcement (Psychology) Respiratory Tract Infections - complications Suggestion Syndrome Tic Disorders - psychology Time Factors Treatments |
title | The cough and the bedsheet |
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