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Association Between Extrapulmonary Chronic Cough and Psychiatric Comorbidities
William A Strober1, Dorina Kallogjeri1, Matthew L Rohlfing1
1Department of Otolaryngology, Washington University School of Medicine, St. Louis, Missouri, USA.
Objective:
Chronic cough is a highly prevalent condition that significantly reduces quality of life, but our current understanding of the association between chronic cough and psychiatric comorbidities is limited. This study aims to describe the association between extrapulmonary chronic cough (ECC) and psychiatric comorbidities using a validated national database analysis.
Methods:
The National Health and Nutrition Examination Survey (NHANES) was used to identify participants with ECC between 2007 and 2012. Participant demographic information and diagnoses were obtained from the results of these surveys. Multivariable logistic regression was used to assess associations between ECC and psychiatric comorbidities after controlling for several confounding factors including demographic variables and other comorbidities known to be associated with chronic cough.
Results:
This study included a total of 9941 participants, corresponding to a weighted total of 123,419,943 participants. Of these, 5,753,420 (4.6%) had pulmonary-related chronic cough, 7,947,586 (6.4%) had ECC, and 109,718,937 (88.9%) had no chronic cough. There was a clinically and statistically significant association between ECC and depression severity (PHQ-9 categories) (mild OR: 1.7 [99% CI: 1.1-2.5], moderate OR: 1.9 [99% CI: 1.1-3.2], severe OR: 3.5 [99% CI: 0.83-14.32]). There was also a strong association between ECC and anxiety (OR: 1.9 [99% CI: 1.3-2.8]).
Conclusion:
There are strong associations between ECC and both depression and anxiety. Physicians should consider the possible bidirectional impact of psychiatric comorbidities and chronic cough.
Level Of Evidence:
Level 3.
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