More than half of patients with chronic cough have symptoms of depression, researchers report at the American Thoracic Society international conference.

The New York study of individuals with chronic cough showed that more than half had reduced quality-of-life scores, which increased their risk for depression.

"Cough is among the most common complaints for which patients seek medical attention," says Peter V. Dicpinigaitis, MD, director of the Montefiore Cough Center in New York. "They are socially isolated and miserable. They don't want to go to restaurants, concerts, or the ballet. Their cough affects their relationships and their jobs."

"Doctors need to be aware that their patients with chronic cough may be depressed," Dicpinigaitis tells WebMD.

Chronic Cough a Risk for Depression

One hundred patients entering a New York-based cough clinic were given a 20-item self-report questionnaire measuring depression symptoms. Those with a score of 16 or more were considered to have significant depressive symptoms and be at risk for depression.

The group's average depression score was 18, with more than half (55 percent) of the patients having a score of 16 or higher. Some of the patients reached 30 or 40 out of a high score of 60, Dicpinigaitis says.

The study showed an equal amount of depression among female and male chronic coughers.

Richard Irwin, MD, professor of medicine and nursing at the University of Massachusetts Nursing School in Worcester, Mass., says the findings aren't a surprise since chronic cough affects both one's physical and psychosocial health.

"But this is suggestive data," he says. "The study lacked a control group of noncoughers and individuals who cough but who aren't bothered by it, such as smokers."

Chronic cough has three main causes, either alone or in combination, including postnasal drip, asthma, and heartburn when the acid from the stomach comes up and creates irritation, says Dicpinigaitis.

"The diagnosis often is difficult because the only symptom that many patients have is cough."

When the cough was treated, 50 of the participants improved significantly, with depression scores dropping from an average score of 18 to 4.

Participants whose coughs didn't improve also didn't have a significant improvement in depressive symptoms. At the start, their depressive symptom scores were 18 on average but dropped to 15 after unsuccessful treatment.

Though chronic cough doesn't kill people, it does cause physical fatigue, muscle aches and pains, poor sleep, and in some cases urinary incontinence, he notes.

"Many patients give up after going from doctor to doctor and at times being told to live with it," he says. "My advice for chronic coughers is to not give up on getting help. The majority of people can be helped."

By Linda Little, reviewed by Brunilda Nazario, MD


SOURCE: American Thoracic Society 2005 International Conference, San Diego, May 20-25, 2005. Peter V. Dicpinigaitis, MD, director, Montefiore Cough Center, New York.