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No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies

Adverse side effects are reported by a large proportion of patients undergoing medical treatment in clinical practice or clinical trials. Nocebo effects, induced by negative treatment expectancies, can contribute to negative patient-reported outcomes but have rarely been studied in the context of in...

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Autores principales: Benson, Sven, Elsenbruch, Sigrid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652147/
https://www.ncbi.nlm.nih.gov/pubmed/31379627
http://dx.doi.org/10.3389/fpsyt.2019.00511
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author Benson, Sven
Elsenbruch, Sigrid
author_facet Benson, Sven
Elsenbruch, Sigrid
author_sort Benson, Sven
collection PubMed
description Adverse side effects are reported by a large proportion of patients undergoing medical treatment in clinical practice or clinical trials. Nocebo effects, induced by negative treatment expectancies, can contribute to negative patient-reported outcomes but have rarely been studied in the context of inflammatory or immune-related conditions. Based on perceived treatment allocation, we herein analyzed nocebo responders in the placebo arms of randomized controlled double-blind experimental endotoxemia studies. We hypothesized that nocebo responders would report more bodily sickness symptoms and greater mood impairment. Out of N = 106 participants who had all received placebo injection, N = 20 (18.9%) wrongly believed they had received endotoxin and were thus considered as nocebo responders. Nocebo responders reported significantly more bodily sickness symptoms, suggesting that the perception of bodily symptoms affected perceived treatment allocation. Against our expectations, we did not find differences between nocebo responders and controls in psychological or physiological parameters. However, exploratory correlational analysis within nocebo responders revealed that more pronounced bodily sickness symptoms in response to placebo were associated with greater state anxiety and negative mood, as well as with the psychological traits catastrophizing and neuroticism. Our findings support that negative affectivity and personality-related factors may contribute to the reporting of sickness symptoms. Nonspecific symptoms experienced by patients undergoing pharmacological treatments or in randomized controlled trials can be misinterpreted and/or misattributed as unwanted side effects affecting perceived treatment allocation and presumably treatment satisfaction or its perceived efficacy. More nocebo research in the context of acute and chronic inflammatory conditions is warranted.
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spelling pubmed-66521472019-08-02 No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies Benson, Sven Elsenbruch, Sigrid Front Psychiatry Psychiatry Adverse side effects are reported by a large proportion of patients undergoing medical treatment in clinical practice or clinical trials. Nocebo effects, induced by negative treatment expectancies, can contribute to negative patient-reported outcomes but have rarely been studied in the context of inflammatory or immune-related conditions. Based on perceived treatment allocation, we herein analyzed nocebo responders in the placebo arms of randomized controlled double-blind experimental endotoxemia studies. We hypothesized that nocebo responders would report more bodily sickness symptoms and greater mood impairment. Out of N = 106 participants who had all received placebo injection, N = 20 (18.9%) wrongly believed they had received endotoxin and were thus considered as nocebo responders. Nocebo responders reported significantly more bodily sickness symptoms, suggesting that the perception of bodily symptoms affected perceived treatment allocation. Against our expectations, we did not find differences between nocebo responders and controls in psychological or physiological parameters. However, exploratory correlational analysis within nocebo responders revealed that more pronounced bodily sickness symptoms in response to placebo were associated with greater state anxiety and negative mood, as well as with the psychological traits catastrophizing and neuroticism. Our findings support that negative affectivity and personality-related factors may contribute to the reporting of sickness symptoms. Nonspecific symptoms experienced by patients undergoing pharmacological treatments or in randomized controlled trials can be misinterpreted and/or misattributed as unwanted side effects affecting perceived treatment allocation and presumably treatment satisfaction or its perceived efficacy. More nocebo research in the context of acute and chronic inflammatory conditions is warranted. Frontiers Media S.A. 2019-07-17 /pmc/articles/PMC6652147/ /pubmed/31379627 http://dx.doi.org/10.3389/fpsyt.2019.00511 Text en Copyright © 2019 Benson and Elsenbruch http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Benson, Sven
Elsenbruch, Sigrid
No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies
title No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies
title_full No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies
title_fullStr No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies
title_full_unstemmed No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies
title_short No Reason to Feel Sick? Nocebo Responses in the Placebo Arms of Experimental Endotoxemia Studies
title_sort no reason to feel sick? nocebo responses in the placebo arms of experimental endotoxemia studies
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652147/
https://www.ncbi.nlm.nih.gov/pubmed/31379627
http://dx.doi.org/10.3389/fpsyt.2019.00511
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