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...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Pediatrics (Evanston) 1984-07, Vol.74 (1), p.11-15
Hauptverfasser: COHLAN, S. Q, STONE, S. M
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 15
container_issue 1
container_start_page 11
container_title Pediatrics (Evanston)
container_volume 74
creator COHLAN, S. Q
STONE, S. M
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
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_81136675</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>81136675</sourcerecordid><originalsourceid>FETCH-LOGICAL-c315t-f27672e9792d4d6af03ef6ebc7b3d100f2b0bfa25ed1bae1a6a9c97ec00cd0893</originalsourceid><addsrcrecordid>eNo9kE1Lw0AQhhdRaq3ePAlCD-LJxJndbDZ7lOIXFLzU87Ifs7aSNjWbHPz3Rhp6Gob3mQfmZewaIUdZ8Mc9hZSrIscc8YRNEXSVFVzJUzYFEJgVAPKcXaT0DQCFVHzCJqUSmoOYspvVmua-6b_Wc7sL827Y3OBbE3WX7CzaOtHVOGfs8-V5tXjLlh-v74unZeYFyi6LXJWKk1aahyKUNoKgWJLzyomAAJE7cNFySQGdJbSl1V4r8gA-QKXFjN0fvPu2-ekpdWa7SZ7q2u6o6ZOpEEVZKjmADwfQt01KLUWzbzdb2_4aBPNfhfmvwqjCoBluZux29PZuS-EIj78P-d2Y2-RtHVu785t0xCqtUAKKP-0eZVs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>81136675</pqid></control><display><type>article</type><title>The cough and the bedsheet</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>COHLAN, S. 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&amp;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>
fulltext fulltext
identifier ISSN: 0031-4005
ispartof Pediatrics (Evanston), 1984-07, Vol.74 (1), p.11-15
issn 0031-4005
1098-4275
language eng
recordid cdi_proquest_miscellaneous_81136675
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
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T07%3A00%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20cough%20and%20the%20bedsheet&rft.jtitle=Pediatrics%20(Evanston)&rft.au=COHLAN,%20S.%20Q&rft.date=1984-07&rft.volume=74&rft.issue=1&rft.spage=11&rft.epage=15&rft.pages=11-15&rft.issn=0031-4005&rft.eissn=1098-4275&rft.coden=PEDIAU&rft_id=info:doi/10.1542/peds.74.1.11&rft_dat=%3Cproquest_cross%3E81136675%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=81136675&rft_id=info:pmid/6739203&rfr_iscdi=true