Hiccups of psychogenic origin: A case report and review of the literature

A case of intractable hiccups, with an extensive investigation of the psychogenic origin of the hiccups and their treatment, is presented together with a review of the literature. The hiccups in this case are best characterized as a conversion reaction, representing repressed hostility and guilt over sexual conflicts in the patient and her family constellation. Treatment by hypnotic suggestion, directed at symptom removal, was combined with a slight modification of the interaction between the patient and her family. At ten month follow-up, the patient was functioning in a much more satisfactory level and had had only a few brief episodes of hiccups in the intervening time. It is suggested that the psychogenic mechanisms of hiccups deserve further attention and that individuals with intractable hiccups should have a full psychosocial evaluation as early as possible in the medical management program.