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Nature Reviews. Urology Mar 2022A placebo is an inert substance normally used in clinical trials for comparison with an active substance. However, a placebo has been shown to have an effect on its own;... (Review)
Review
A placebo is an inert substance normally used in clinical trials for comparison with an active substance. However, a placebo has been shown to have an effect on its own; commonly known as the placebo effect. A placebo is an essential component in the design of conclusive clinical trials but has itself become the focus of intense research. The placebo effect is partly the result of positive expectations of the recipient on the state of health. Conversely, a nocebo effect is when negative expectations from a substance lead to poor treatment outcomes and/or adverse events. Randomized controlled trials in functional urology have demonstrated the importance of the placebo and nocebo effects across different diseases such as overactive bladder, urinary incontinence, lower urinary tract symptoms and interstitial cystitis/painful bladder syndrome, as well as male and female sexual dysfunction. Understanding the true nature of the placebo-nocebo complex and the scope of its effect in functional urology could help urologists to maximize the positive effects of this phenomenon while minimizing its potentially negative effects.
Topics: Female; Humans; Lower Urinary Tract Symptoms; Male; Nocebo Effect; Placebo Effect; Treatment Outcome; Urology
PubMed: 34949831
DOI: 10.1038/s41585-021-00545-2 -
Headache Mar 2015Alternative and complementary medicines such as acupuncture remain popular with the general public and many clinicians. The term "integrative medicine" is often now used... (Review)
Review
BACKGROUND
Alternative and complementary medicines such as acupuncture remain popular with the general public and many clinicians. The term "integrative medicine" is often now used to describe this type of non-science-based medicine, which has become more of a faith-based method of practice, making it harder to challenge. Acupuncture is commonly used to treat headache along with just about any other symptom and condition known to man.
DISCUSSION
Physicians regularly fall into many misunderstandings when erroneously believing a real effect from acupuncture, when there is none. A perfunctory and poorly informed media contribute to the misinformation. Sixteen logical traps are identified which together explain most of the false reasoning behind the alleged effect of acupuncture.
CONCLUSION
Practitioners need to do a better job of discerning truth from information and data available on acupuncture.
Topics: Acupuncture Therapy; Complementary Therapies; History, 19th Century; History, 20th Century; History, Ancient; Humans; Pain; Pain Management; Placebo Effect
PubMed: 25660556
DOI: 10.1111/head.12524 -
Psychoneuroendocrinology Jul 2019Placebos are usually employed deceptively in clinical trials in order to control for non-specific effects. However, since placebos themselves have been found to cause... (Review)
Review
Placebos are usually employed deceptively in clinical trials in order to control for non-specific effects. However, since placebos themselves have been found to cause clinically relevant changes and in some cases are indistinguishable from the verum they are tested against, this theoretically inert, but practically effective intervention has become a scientific discipline in its own right. In this review, it is argued that placebos are generic and genuine biopsychosocial interventions and as such are highly interesting candidates for a psychoneuroendocrinological perspective. Yet, despite a considerable conceptual proximity between explanatory models of placebos and their effects with psychoneuroendocrine models and findings, placebos have thus far not been subject to systematic psychoneuroendocrine examination. Consequently, it would be highly interesting and informative to make placebos the target of psychoneuroendocrine scrutiny.
Topics: Conditioning, Psychological; Humans; Neuroendocrinology; Placebo Effect; Placebos
PubMed: 30098833
DOI: 10.1016/j.psyneuen.2018.08.008 -
Osteoarthritis and Cartilage Nov 2016This paper reviews some recent advances in our understanding of the effects of sham or dummy interventions on pain and other symptoms in osteoarthritis (OA), and... (Review)
Review
This paper reviews some recent advances in our understanding of the effects of sham or dummy interventions on pain and other symptoms in osteoarthritis (OA), and outlines two new approaches to the investigation of placebo and nocebo effects. We argue that the placebo effect provides us with a valuable way of investigating the nature of conditions like OA. For example, by examining which symptoms, biochemical markers or imaging features do or do not respond to placebo, we might learn more about the relationships between pathology and symptoms in OA. Placebo and nocebo effects are positive or negative outcomes resulting from the human interactions and contexts in which healthcare consultations take place. Subtle changes in behaviours and the environments in which consultations take place can have major effects on pain and other symptoms being experienced by people with OA. Nocebo effects are particularly powerful, leading to many health-care professionals (HCPs) causing unintended harm to their clients. Based on our own research, we conclude that beneficial outcomes are most likely to occur when both the (HCP) and the client feel safe and relaxed, and when the experiences of the client are validated by the (HCP). These findings have important implications for clinical practice. We believe that research in this field needs to be 'trans-disciplinary', escaping from the constraints of the purely biomedical, deterministic, positivist paradigm of most medical research. We provide the example of our own work which combines performance studies and scholarship, with psychology and medicine.
Topics: Biomedical Research; Humans; Nocebo Effect; Osteoarthritis; Pain; Placebo Effect
PubMed: 27338671
DOI: 10.1016/j.joca.2016.06.007 -
Der Nervenarzt Aug 2020In the past few decades, research on pain and placebo analgesia has gained importance both scientifically and clinically. In this article, the current findings and focus... (Review)
Review
In the past few decades, research on pain and placebo analgesia has gained importance both scientifically and clinically. In this article, the current findings and focus of research as well as the significance of placebo research for assessing the effectiveness of pain medication are illustrated. The underlying mechanisms of placebo analgesia not only have implications for theoretical models but also offer clinically relevant guidelines for everyday interventions in pain treatment. However, many placebo phenomena are not fully understood and have to be investigated further in order to exploit the full potential of placebo effects. Interindividual differences and their inclusion in treatment will play a major role in this aspect.
Topics: Analgesia; Humans; Pain; Pain Management; Placebo Effect
PubMed: 32642945
DOI: 10.1007/s00115-020-00942-9 -
Inflammatory Bowel Diseases Sep 2023
Topics: Humans; Crohn Disease; Remission Induction; Placebo Effect
PubMed: 36426807
DOI: 10.1093/ibd/izac240 -
Nature Reviews. Neurology Oct 2022Functional neurological disorder (FND) is characterized by neurological symptoms that cannot be explained by a structural neurological cause. Among the different... (Review)
Review
Functional neurological disorder (FND) is characterized by neurological symptoms that cannot be explained by a structural neurological cause. Among the different aetiological models that have been proposed for FND, of note is the Bayesian predictive coding model, which posits that perception relies on top-down cortical predictions (priors) to infer the source of incoming sensory information. This model can also apply to non-pathological experiences, such as placebo and nocebo effects, wherein sensory information is shaped by prior expectations and learning. To date, most studies of the relationship between placebo and nocebo effects and FND have focused on the use of placebos for diagnosis and treatment of FND. Here, we propose that this relationship might go beyond diagnosis and therapy. We develop a framework in which shared cognitive, personality and neuroanatomical factors justify the consideration of a deeper link between FND and placebo and nocebo effects. This new perspective might offer guidance for clarification of the pathogenesis of FND and for the identification of potential biomarkers and therapeutic targets.
Topics: Bayes Theorem; Conversion Disorder; Humans; Nocebo Effect; Placebo Effect
PubMed: 36075980
DOI: 10.1038/s41582-022-00711-z -
International Review of Neurobiology 2020The placebo effect is a widely recognized phenomenon in clinical research, with a negative perception that it could hide the "true" drug effect. In clinical care its... (Review)
Review
The placebo effect is a widely recognized phenomenon in clinical research, with a negative perception that it could hide the "true" drug effect. In clinical care its positive potential to increase known drug effects has been neglected for too long. The placebo and nocebo responses have been described in many neurologic disorders such as Parkinson's, Huntington's and Alzheimer's diseases, restless leg syndrome, tics, essential tremor, dystonia, functional movement disorders, neuropathic pain, headaches, migraine, amyotrophic lateral sclerosis, myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, multiple sclerosis and epilepsy. Knowledge regarding placebo mechanisms and their consequences on clinical outcome have greatly improved over the last two decades. This evolution has led to reconsiderations of the importance of placebo response in the clinic and has given several clues on how to improve it in daily practice. In this chapter, we first illustrate "why," e.g. the reasons (relevance to clinical practice, help in differential diagnosis/treatment of psychogenic movements, clinical impact, proven neurobiological grounds, health economic potential), and "how," e.g. the means (increase patients' knowledge, increase learning, improve patient-doctor relationship, increase Hawthorne effect, increase positive/decrease negative expectations (the Rosenthal effect), personalize placebo response), the placebo should be maximized (and nocebo avoided) in neurological clinical practice. Future studies regarding more specific neurobiological mechanisms will allow a finer tuning of placebo response in clinical practice. The use of placebo in clinical practice raises ethical issues, and a recent expert consensus regarding placebo use in the clinic is a first step to future guidelines necessary to this field.
Topics: Humans; Nervous System Diseases; Personality; Placebo Effect; Placebos
PubMed: 32563294
DOI: 10.1016/bs.irn.2020.04.003 -
Translational Psychiatry Dec 2022Placebo and nocebo effects are salubrious benefits and negative outcomes attributable to non-specific symbolic components. Leveraging advanced experimental and... (Review)
Review
Placebo and nocebo effects are salubrious benefits and negative outcomes attributable to non-specific symbolic components. Leveraging advanced experimental and analytical approaches, recent studies have elucidated complicated neural mechanisms that may serve as a solid basis for harnessing the powerful self-healing and self-harming capacities and applying these findings to improve medical practice and minimize the unintended exacerbation of symptoms in medical practice. We review advances in employing psychosocial, pharmacological, and neuromodulation approaches to modulate/harness placebo and nocebo effects. While these approaches show promising potential, translating these research findings into clinical settings still requires careful methodological, technical, and ethical considerations.
Topics: Nocebo Effect; Placebo Effect
PubMed: 36564374
DOI: 10.1038/s41398-022-02293-2 -
Perspectives in Biology and Medicine 2018
Topics: Biomedical Research; Humans; Physician-Patient Relations; Placebo Effect; Randomized Controlled Trials as Topic
PubMed: 30293973
DOI: 10.1353/pbm.2018.0047