Transitioning from deceptive to nondeceptive placebo treatment to reduce pathological skin-picking

Deceptive placebos (DPs) have been shown to alleviate symptoms of several mental disorders. However, the willingness of patients to transition from DP treatment to nondeceptive placebos (NDPs) has not been systematically investigated.

This study examined whether individuals with pathological skin-picking (n = 69), who were initially administered oral capsules labeled as N-acetylcysteine (DPs; one per day over two weeks), would consent to continue the same treatment regimen when the capsules were presented as NDPs. The DP and NDP treatments were compared in terms of their reported effectiveness in reducing skin-picking symptoms and difficulties in emotion regulation. The average duration between the start of the DP and NDP trials was 17.4 weeks. Additionally, participants indicated their preference for DP or NDP treatment in an open-ended format.

Following debriefing after the DP trial, 20 participants (mean age = 32 years; male-to-female ratio 1:19) agreed to enter the NDP trial. On average, these participants had reported clinically meaningful symptom reduction during the DP phase. By the end of the study, only four participants expressed a preference for NDPs, which did not result in statistically significant symptom reduction.

The benefits of DP treatment for pathological skin-picking did not carry over to NDPs. Future research could explore whether extended psychoeducation increases the number of NDP responders.