(American Thoracic Society) -- Since over 23 percent of patients with a persistent, troublesome cough who are referred to a cough specialist are diagnosed with "psychogenic cough," experts caution physicians to resist this diagnosis initially.

They say that the most common diseases associated with cough lasting two months or more are postnasal drip syndrome, asthma, and gastroesophageal reflux disease. These illnesses should be considered first despite what appears to be even more "obvious" causes such as smoking or chronic interstitial pneumonia.

According to the experts, a troublesome cough can be due to more than one condition 93 percent of the time and more than two conditions up to 53 percent of the time. Moreover, because chronic cough so adversely affects psychological health, clinicians should be cautious when concluding that any psychosocial dysfunction is the cause rather than the consequence of the cough.

The "Clinical Commentary" appears in the first issue for June of the American Thoracic Society's peer- reviewed American Journal of Respiratory and Critical Care Medicine.