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The Journal of Nervous and Mental... Jul 2013The natural human response to illness is to seek to understand what is happening and to look for help from others. In all cultures, one finds healers, who provide... (Review)
Review
The natural human response to illness is to seek to understand what is happening and to look for help from others. In all cultures, one finds healers, who provide explanations and offer care. Their interventions often have a placebo effect through activation of natural healing processes in the patient. Although placebo effects are relatively large and robust, physicians generally consider placebo treatment prescientific and deceptive. We review the determinants of the placebo response and show how a particular professional alliance between a patient and a caregiver is apt to equally affect treatment outcome. We distinguish the alliance effect from the placebo effect. We develop a comprehensive model of the medical alliance, on the basis of the concept of concordance, and review its relevance for clinical practice and medical education. The alliance effect represents a professional and ethical way of activating a patient's natural healing mechanisms.
Topics: Humans; Physician-Patient Relations; Placebo Effect; Psychological Theory
PubMed: 23817150
DOI: 10.1097/NMD.0b013e31829829e1 -
International Review of Neurobiology 2018
Topics: Animals; Biomedical Research; Humans; Placebo Effect; Placebos
PubMed: 29681338
DOI: 10.1016/S0074-7742(18)30027-8 -
Digestive Diseases (Basel, Switzerland) 1994Placebo, defined as any therapeutic procedure, without any specific activity, given deliberately to have an effect on a patient, symptom, syndrome or disease, has a... (Review)
Review
Placebo, defined as any therapeutic procedure, without any specific activity, given deliberately to have an effect on a patient, symptom, syndrome or disease, has a great impact in the evaluation of drug response. The possible pathways via which the possible effect brings about clinical and physiological changes remain unknown, but a humoral mechanism seems to be implicated in some placebo effects (e.g. placebo-induced analgesia). The placebo effect depends on many factors, including the type of patient, the personality of the physician, the doctor-patient relationship and the type and even the colour of the drug preparation. Placebo control is important particularly when the disease is characterized by frequent spontaneous periods of acute exacerbation and remission. Functional (such as dyspepsia and irritable bowel syndrome) and organic (such as peptic ulcer and inflammatory bowel disease) gastrointestinal diseases have got great benefit from placebo-controlled clinical trials. In such trials the more effective the placebo is, the more difficult it will be to demonstrate the efficacy of active drug in statistical terms. Nevertheless, provided the use of placebo be ethical for a given condition, placebo-controlled trials are the only objective way of assessing correctly drug response in patients.
Topics: Drug Evaluation; Humans; Placebo Effect; Placebos; Randomized Controlled Trials as Topic
PubMed: 7712618
DOI: 10.1159/000171471 -
Revue Medicale de Liege May 2023Functional disorders are clinical entities corresponding to complaints mimicking diseases without a clearly identified organic substrate despite a rigorous history and...
Functional disorders are clinical entities corresponding to complaints mimicking diseases without a clearly identified organic substrate despite a rigorous history and clinical examination. Sometimes, complementary examinations are necessary to rule out an organic lesion that could explain the symptomatology. The notion of a diagnosis of exclusion is therefore very present. The physician must constantly re-evaluate the diagnosis of functional disorder in order not to «miss» a diagnosis with an organic cause.The treatment of these functional disorders is sometimes based on psychological treatment when a psychogenic dimension seems to be involved. This is not always the case. In such cases it is necessary to be able to consider a placebo approach with the hope that the placebo effect may improve the patient's condition. This article discusses the placebo effect in functional disorders without omitting to address ethical and philosophical considerations.
Topics: Humans; Placebo Effect; Disease
PubMed: 37350197
DOI: No ID Found -
Tidsskrift For Den Norske Laegeforening... Sep 2019
Topics: Complementary Therapies; Humans; Physician-Patient Relations; Physicians; Placebo Effect
PubMed: 31502801
DOI: 10.4045/tidsskr.19.0374 -
Psychological Bulletin Mar 2004The authors review the literature on the 2 main models of the placebo effect: expectancy theory and classical conditioning. A path is suggested to dissolving the... (Review)
Review
The authors review the literature on the 2 main models of the placebo effect: expectancy theory and classical conditioning. A path is suggested to dissolving the theoretical impasse that has long plagued this issue. The key is to make a clear distinction between 2 questions: What factors shape placebo effects? and What learning mediates the placebo effect? The reviewed literature suggests that classical conditioning procedures are one shaping factor but that verbal information can also shape placebo effects. The literature also suggests that conditioning procedures and other sources of information sometimes shape conscious expectancies and that these expectancies mediate some placebo effects; however, in other cases conditioning procedures appear to shape placebo effects that are not mediated by conscious cognition.
Topics: Cognition; Conditioning, Psychological; Humans; Placebo Effect
PubMed: 14979775
DOI: 10.1037/0033-2909.130.2.324 -
Annales Pharmaceutiques Francaises Nov 2015After starting with a brief historical account of the placebo effect organized around the elaboration of clinical trials and around sham therapy as a method, we will... (Review)
Review
After starting with a brief historical account of the placebo effect organized around the elaboration of clinical trials and around sham therapy as a method, we will offer a psychosocial point of view on the placebo phenomenon. The placebo effect is at the heart of medicine and particularly of therapeutic trials from theoretical research on a drug to its acceptance and its use in every-day clinical practice. The placebo effect intermingles biology, relationships and the context of therapeutic interactions. This type of phenomenon originates as much from biology as from human psychology. Our article puts more precisely into question the part that psychology has in the placebo phenomenon and suggests a chart to address it. This chart refers both to the pharmacodynamic effect given to drugs in a subjective way, and to the collective representations and social interactions depending on them. What can we say about the psychosociological dimensions of the placebo effect? How is it possible to organize the scope of these dimensions to base systematic studies on them in the field of clinical trials? We try to give elements of response to these questions by suggesting the study of the placebo effect as an original field of study by necessarily mobilizing both health sciences and the human and social sciences.
Topics: Humans; Placebo Effect; Placebos; Psychology, Social
PubMed: 26044499
DOI: 10.1016/j.pharma.2015.04.006 -
Tidsskrift For Den Norske Laegeforening... Oct 2019
Topics: Data Interpretation, Statistical; Humans; Placebo Effect
PubMed: 31642619
DOI: 10.4045/tidsskr.19.0432 -
Clinical Medicine (London, England) Oct 2007It is often stated, paradoxically, that a treatment is not effective when trials have shown a placebo effect. This should be rephrased 'that the tested treatment is not... (Review)
Review
It is often stated, paradoxically, that a treatment is not effective when trials have shown a placebo effect. This should be rephrased 'that the tested treatment is not more effective than the placebo' if we are not to confuse ourselves and the public in the current debate on complementary and alternative medicine.
Topics: Acupuncture; Clinical Trials as Topic; Complementary Therapies; Humans; Pain Management; Placebo Effect; Transcutaneous Electric Nerve Stimulation
PubMed: 17990710
DOI: 10.7861/clinmedicine.7-5-450 -
Pharmacology & Therapeutics Dec 2013The power of a placebo to effect clinically meaningful neurobiological change comparable to pharmacological therapies has been demonstrated, although the mechanisms are... (Review)
Review
The power of a placebo to effect clinically meaningful neurobiological change comparable to pharmacological therapies has been demonstrated, although the mechanisms are not fully understood. Predicting placebo responsiveness has only recently received more attention, but psychological disposition, contextual and biological factors are now known to dramatically affect a person's susceptibility to the placebo effect. The placebo effect depends upon expectancies that can be modified in a number of ways, including conditioning through explicit or implicit learned associations. Based on the dopaminergic response to anticipation of benefit in Parkinson's disease, it was suggested that the placebo effect can be seen as analogous to the expectation of reward. Dopaminergic pathways have since been implicated in the placebo response in pain and depression. Additionally, endogenous opioid release is known to mediate many forms of placebo analgesia. We provide an overview of the mechanisms and the therapeutic implications of the placebo effect in neurological and psychiatric conditions. We include evidence for detrimental effects arising from seemingly inert interventions, termed the 'nocebo effect.' Neuroimaging has critically advanced the study of the placebo effect and provides some of the strongest evidence for the mechanisms of this phenomenon prevalent across an array of human health-related circumstances. This review specifically focuses on mechanisms of the placebo effect in the three conditions that have most significantly demonstrated this effect and for which a plausible physiological basis can be identified: pain, PD and depression. Other neurological and psychiatric diseases reviewed include multiple sclerosis, Huntington's disease, Alzheimer's disease, schizophrenia and epilepsy.
Topics: Animals; Humans; Mental Disorders; Nervous System Diseases; Placebo Effect
PubMed: 23880289
DOI: 10.1016/j.pharmthera.2013.07.009