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The nocebo effect and its relevance for clinical practice.
Luana Colloca1, Franklin G Miller
1Department of Bioethics, Clinical Center, National Institutes of Health, Bldg 10, Room 1C118, Bethesda, MD 20892-1156, USA. luana.colloca@nih.gov
Psychosomatic Medicine
|August 25, 2011
Summary
Negative expectations, or nocebo effects, can cause adverse outcomes. Information disclosure about side effects, even in clinical trials, can trigger these nocebo responses, impacting patient well-being and treatment adherence.
Area of Science:
- Neuroscience
- Clinical Psychology
- Medical Ethics
Background:
- Negative expectations from clinical encounters can lead to adverse outcomes, known as nocebo effects.
- Information disclosure about potential side effects can paradoxically induce these adverse effects.
- Neurobiological mechanisms underlie the nocebo effect, yet clinical implications require further exploration.
Purpose of the Study:
- To provide a selective review of mechanistic research on the nocebo effect.
- To highlight the implications of nocebo effects in clinical practice and daily patient care.
- To examine the influence of information presentation in clinical trials on nocebo responses.
Main Methods:
- Selective review of mechanistic research on the nocebo effect.
- Analysis of clinical studies and their practical implications.
- Examination of neurobiological underpinnings and patient communication strategies.
Main Results:
- Nocebo effects are influenced by how information is presented to patients, affecting both placebo and active treatment groups.
- These effects negatively impact patient quality of life and adherence to therapies.
- The informed consent process in clinical trials may inadvertently induce nocebo effects.
Conclusions:
- Minimizing nocebo responses is crucial for improving patient outcomes and adherence.
- Ethical considerations for patient-oriented research and routine practice are necessary.
- Further research should focus on mitigating nocebo effects in clinical settings.
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