@article{3020332,
    title = "Increased incidence of stress-related tic habit cough in children during the recent greek financial crisis",
    author = "Papadopoulou, A. and Mermiri, D.-Z.T. and Gritzelas, G. and Tsouridi, O. and Dimara, E. and Yapijakis, C. and Chrousos, G.P.",
    journal = "In vivo (Athens, Greece)",
    year = "2021",
    volume = "35",
    number = "3",
    pages = "1811-1820",
    publisher = "International Institute of Anticancer Research",
    doi = "10.21873/invivo.12442",
    keywords = "bronchodilating agent;  immunoglobulin E;  steroid, anxiety disorder;  Article;  bullying;  child;  chronic cough;  cognitive behavioral therapy;  controlled study;  cross-sectional study;  distractibility;  family;  female;  financial crisis;  girl;  Greece;  human;  incidence;  learning disorder;  major clinical study;  male;  patient referral;  peer group;  physiological stress;  prospective study;  psychogenic cough;  school child;  tic;  coughing;  habit;  tic, Child;  Cough;  Cross-Sectional Studies;  Female;  Greece;  Habits;  Humans;  Incidence;  Prospective Studies;  Tics",
    abstract = "Background/Aim: Tic habit cough (THC) is not easily recognized and requires a high index of suspicion. Since there is evidence for stress-related etiology, the study presents our experience during the eight-year period of the recent Greek financial crisis. Patients and Methods: This is a descriptive prospective cross-sectional clinical study using a consistent approach to diagnosis, possible triggers and treatment options. Results: Fifty-one children (26 girls, age 9.5±3.1y) from a total of 3,793 new referrals for chronic cough fulfilled the criteria of THC (1.34%). Incidence rates per 1,000 person-years were 1.34 (95%CI=0.34-5.40), 3.91 (95%CI=1.86-8.19), 4.03 (95%CI=2.01-8.06) and 14.60 (95%CI=10.43-20.44) for every two years. Poisson analysis showed an increased trend during the four time periods with an incidence rate ratio equal to 2.21 (95%CI=1.58-3.09, p<0.001). THC was mainly attributed to learning difficulties, as well as stress-related impact of peer or family bullying, family financial problems and child anxiety disorders. Conclusion: The incidence of THC is associated with the negative aspects of stressors during a period of financial crisis. The potential underlining psycho-physiological mechanisms are discussed as well as the fact that prompt diagnosis may result in successful interventions. © 2021 International Institute of Anticancer Research. All rights reserved."
}