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Nocebo effect, not placebo effect: Induced illness studied

Date:
July 12, 2012
Source:
Deutsches Aerzteblatt International
Summary:
Negative suggestion can induce symptoms of illness. Nocebo effects are the adverse events that occur during sham treatment and/or as a result of negative expectations. While the positive counterpart —- the placebo effect -— has been intensively studied in recent years, the scientific literature contains few studies on nocebo phenomena. Researchers now present the underlying neurobiological mechanisms and highlight the relevance of the nocebo effect in everyday clinical practice.
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Negative suggestion can induce symptoms of illness. Nocebo effects are the adverse events that occur during sham treatment and/or as a result of negative expectations. While the positive counterpart -- the placebo effect -- has been intensively studied in recent years, the scientific literature contains few studies on nocebo phenomena. In the latest issue of Deutsches Ärzteblatt International, Winfried Häuser of the Technical University of Munich and his co-authors present the underlying neurobiological mechanisms and highlight the relevance of the nocebo effect in everyday clinical practice.

Nocebo responses can, for instance, be brought about by unintended negative suggestion on the part of doctors or nurses, e.g., when informing the patient about the possible complications of a proposed treatment. It is also assumed that a certain proportion of the undesired effects of drugs can be attributed to nocebo effects. The mechanisms behind this phenomenon are -- as with placebo effects -- learning by Pavlovian conditioning and reaction to induced expectations.

What are the consequences for clinical practice? Doctors find themselves in an ethical dilemma between their obligation to tell the patient about the possible side effects of a treatment and their duty to minimize the risk of a medical intervention and thus to avoid triggering nocebo effects. As one possible strategy to solve this dilemma, Häuser et al. suggest emphasizing the tolerability of therapeutic measures. Another option, with the patient's permission, would be to desist from discussing undesired effects during the patient briefing.


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The above post is reprinted from materials provided by Deutsches Aerzteblatt International. Note: Materials may be edited for content and length.


Journal Reference:

  1. Häuser W, Hansen E, Enck P. Nocebo phenomena in medicine: their relevance in everyday clinical practice. Dtsch Arztebl Int, 2012; 109(26): 459%u201365 DOI: 10.3238/arztebl.2012.0459

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Deutsches Aerzteblatt International. "Nocebo effect, not placebo effect: Induced illness studied." ScienceDaily. ScienceDaily, 12 July 2012. <www.sciencedaily.com/releases/2012/07/120712092515.htm>.
Deutsches Aerzteblatt International. (2012, July 12). Nocebo effect, not placebo effect: Induced illness studied. ScienceDaily. Retrieved September 3, 2015 from www.sciencedaily.com/releases/2012/07/120712092515.htm
Deutsches Aerzteblatt International. "Nocebo effect, not placebo effect: Induced illness studied." ScienceDaily. www.sciencedaily.com/releases/2012/07/120712092515.htm (accessed September 3, 2015).

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