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Rethinking placebo in psychiatry: how and why placebo effects occur

  • Daniel McQueen, Sarah Cohen, Paul St John-Smith and Hagen Rampes


This article outlines proximate (physical and mental) and ultimate mechanisms of placebo effects. Interpersonal processes contributing to placebo effects are reviewed and illustrated through research into the process of psychotherapy. Evolutionary theories of how and why the capacity for placebo effects might have evolved are described. The components of treatment and placebo effects are defined. It is concluded that maximising therapeutic placebo effects is effective and a valid clinical goal.

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Corresponding author

Dr Daniel McQueen, Child and Adolescent Mental Health Service, Royal Free Hampstead NHS Foundation Trust, Pond Street, London NW3 2QG, UK. Email:


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McQueen et al discuss the range of placebo effects on pp. 162–170, this issue.

Declaration of Interest




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BJPsych Advances
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Rethinking placebo in psychiatry: how and why placebo effects occur

  • Daniel McQueen, Sarah Cohen, Paul St John-Smith and Hagen Rampes
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