心因性咳嗽の1女児例

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A 12-year-old girl was admitted to our hospital because of a recurrent cough and headache. They had both begun 34 months prior to the admission, when she had had an upper respiratory infection. The cough was non-productive and occurred frequently when she was speaking, but never during sleep.Physical and neurological examination revealed no abnormality. Complete blood counts and biochemical and serological studies were unremarkable. Radiography of the chest and electroencephalography were normal. Pulmonary function tests, including a spirogram and a maximum expiratory flow volume curve, were performed, but the patient couldn't participate well enough to obtain reliable data. A methacholine inhalation challenge test revealed no obvious hyperresponsiveness. On psychological evaluation, an intropunitive tendency on frustration and a desire for dependency were suspected. Also, it seemed that she thought her mother didn't have very intimate affection toward her.Her persistent cough was diagnosed as a psychogenic cough, so she was treated by means of psychotherapeutic approaches including family counseling. We tried the "bedsheet technique" on her, and the cough stopped within two days after its application. Pulmonary function tests showed no obstructive dysfunction later.We think that a psychogenic cough is not rate in children. A psychosomatic approach is important when dealing with a chronic recurrent cough.
日本心身医学会の論文
1989-12-01