Jakati Praveen Kumar, Naskar Subrata, Khanna Anisha
Department of Neuropsychiatry, Institute of Neurosciences, Kolkata, West Bengal, India.
Department of Neuropsychology, Institute of Neurosciences, Kolkata, West Bengal, India.
Indian J Psychol Med. 2017 Jul-Aug;39(4):542-545. doi: 10.4103/0253-7176.211768.
A 9-year-old girl presented with 2-month history of continuous coughing; despite detailed evaluation, no organic cause was found. Considering the provisional diagnosis of a psychogenic cough, she was advised for psychiatry consultation. After a psychological assessment, she was found to have comorbid anxiety (Screen for Child Anxiety Related Disorders score- 25) along with punitive parenting and sibling rivalry issues. She was initially treated with parental psychoeducation, play therapy, and behavior therapy. Since she did not show expected progress with the treatment, low-dose escitalopram was started along with the ongoing therapy, considering her anxiety. There was a significant improvement in her symptoms in 1-month follow-up. She maintained improvement during further follow-ups. This case illustrates the need to identify and treat comorbid psychiatric issues in the management of a psychogenic cough.
一名9岁女孩有持续咳嗽2个月的病史；尽管进行了详细评估，但未发现器质性病因。考虑到初步诊断为心因性咳嗽，建议她去精神科咨询。经过心理评估，发现她同时患有焦虑症（儿童焦虑相关障碍筛查量表得分 - 25），并存在惩罚性育儿和同胞竞争问题。她最初接受了家长心理教育、游戏治疗和行为治疗。由于她在治疗中未显示出预期进展，考虑到她的焦虑症，在继续治疗的同时开始使用低剂量艾司西酞普兰。在1个月的随访中，她的症状有显著改善。在进一步随访期间，她保持了改善状态。该病例说明了在心因性咳嗽管理中识别和治疗共病精神问题的必要性。
