Beware the Nocebo Effect

The placebo effect is a result of the patient’s expectation that the treatment will help.

But expectations can also do harm. When a patient anticipates a pill’s possible side effects, he can suffer them even if the pill is fake. This “nocebo” effect has been largely overlooked by researchers, clinicians and patients.

We…reviewed 31 studies, conducted by us and other researchers, that demonstrated the nocebo effect.

More on this nocebo effect and its implications in The New York Times.

Comments (10)

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  1. Otis says:

    This might have something to do with the underlying factors that cause hypochondria. I really don’t know, actually, I’m just trying to make an educated guess. It seems that people that think that they are going to experience symptoms or side effects……l..they very may.

    The whole mind-body connection is fascinating, really. I look forward to what further research finds on this area.

  2. Devon Herrick says:

    This is the problem with disclosing the long list of possible side effects on the medical disclaimer. Pills that often that are little more effective than a placebo alert people to very rare side effects that patients then go on to have.

  3. Nichole says:

    Mind over matter seems to be the cause of reaction.

  4. Steve says:

    Good point, Devon.

    I really would like to see more studies on the placebo and nocebo effect from researchers.

  5. Kyle says:

    Hm, I wonder which medication they prescribe to counteract the nocebo effect.

  6. Robert says:

    “But in reality the participants received glucose, which does not harm the gut. Nonetheless, 44 percent of people with known lactose intolerance and 26 percent of those without lactose intolerance complained of gastrointestinal symptoms.”

    At the risk of sounding negative or dismissive, I feel that many people have a tendency towards expecting the worst and complaining. The brain has a profoundly powerful effect on controlling the body, which has long been known and demonstrated in multiple ways such as biofeedback and deep meditation (http://www.news.harvard.edu/gazette/2002/04.18/09-tummo.html).

    It comes as no surprise to me then that people who may have a tendency towards hypochondria may focus on the perceived negative outcome and, in fact, create false symptoms for themselves.

  7. Dayana Osuna says:

    A perfect example that defines the concept of “Mind over Matter.”

    Kind of similar to what they say about negative people attracting negative people. If all you have in your head is negative thoughts about negative side-effects and worries just about anything…then that’s probably what you will get.

  8. Molly says:

    Expectations equal unhappiness! Don’t expect…and you won’t be disappointed.

  9. August says:

    “Words are the most powerful tool a doctor possesses, but words, like a two-edged sword, can maim as well as heal.” – Bernard Lown

    So here we have scientific confirmation of the importance of positive doctor-patient communication. What is the best way to implement this best practice?

  10. Tom Emerick says:

    Nice post on “nocebos”.

    If there is up, there is also down. Same with matter and antimatter. In my writing I refer that that effect as anti-placebos, which are found in overabundance in corporate wellness and prevention programs. We are worrying people sick in America.

    Nortin Hadler, MD, and University of North Carolina professor, wrote a terrific book on the subject called…what else?…”Worried Sick.”

    Cheers,

    tom