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Rethinking placebo in psychiatry: the range of placebo effects

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

Summary

This article, the first of two on placebo effects, provides a broad overview of placebo in the field of medicine. A brief conceptual history is followed by some basic facts about placebos. Problems of definition are identified. Additive and non-additive models of treatment effects, and problems of measurement of placebo effects are described. The role of placebo in the pharmacotherapy of depression and complementary and alternative medicine is discussed. The ‘efficacy paradox’ (that placebo treatments can have larger effects than ‘evidence-based treatments’) is introduced. Finally, ethical issues are discussed.

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Copyright

Corresponding author

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

Footnotes

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McQueen et al discuss how and why placebo effects occur on pp. 171–180, this issue.

Declaration of Interest

None.

Footnotes

References

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Ablon, JS, Jones, EE (1998) How expert clinicians' prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioral therapy. Psychotherapy Research 8: 7183.
Ader, R (2000) The placebo effect: if it's all in your head, does that mean you only think you feel better? Advances in Mind–Body Medicine 16: 711.
Aronson, J (1999) Please, please me. BMJ 318: 716.
Beecher, HK (1955) The powerful placebo. JAMA 159: 1602–6.
Benedetti, F, Amanzio, M, Maggi, G (1995) Potentiation of placebo analgesia by proglumide. Lancet 346: 1231.
Benedetti, F, Maggi, G, Lopiano, L et al (2003) Open versus hidden medical treatments: the patient's knowledge about a therapy affects the therapy outcome. Prevention & Treatment 6: June (doi: 10.1037/1522-3736.6.1.61a).
Brotman, DJ, Golden, SH, Wittstein, IS (2007) The cardiovascular toll of stress. Lancet 370: 1089–100.
Ernst, E, Resch, KL (1995) Concept of true and perceived placebo effects. BMJ 311: 551–3.
Ernst, E (2011) Placebo: Trick or Treatment: The Role of The Placebo in Clinical Care. Royal Society of Medicine.
Finniss, DG, Kaptchuk, TJ, Miller, F et al (2010) Biological, clinical, and ethical advances of placebo effects. Lancet 375: 686–95.
Gaudiano, BA, Herbert, JD (2005) Methodological issues in clinical trials of antidepressant medications: perspectives from psychotherapy outcome research. Psychotherapy and Psychosomatics 74: 1725.
Goldacre, B (2008) Bad Science. Fourth Estate.
G⊘tzsche, PC (1994) Is there logic in the placebo? Lancet 344: 925–6.
Grunbaum, A (1981) The placebo concept. Behaviour Research and Therapy 19: 157–67.
Hahn, RA (1997) The nocebo phenomenon: concept, evidence, and implications for public health. Preventive Medicine 26: 607–11.
Hróbjartsson, A, G⊘tzsche, PC (2010) Placebo interventions for all clinical conditions. Cochrane Database of Systematic Reviews 1: CD003974.
Kaptchuk, TJ (1998) Powerful placebo: the dark side of the randomised controlled trial. Lancet 351: 1722–5.
Kaptchuk, TJ (2002) The placebo effect in alternative medicine: can the performance of a healing ritual have clinical significance? Annals of Internal Medicine 136: 817–25.
Kaptchuk, TJ, Kerr, CE, Zanger, A (2009) The art of medicine: placebo controls, exorcisms, and the devil. Lancet 374: 1234–5.
Kaptchuk, TJ, Friedlander, E, Kelley, JM et al (2010) Placebos without deception: a randomized controlled trial in irritable bowel syndrome. PLOS One 5 (12): e15591.
Kennedy, WP (1961) The nocebo reaction. Medical World 95: 203–5.
Kiecolt-Glaser, JK, Mcguire, L, Robles, TF et al (2002) Emotions, morbidity and mortality: new perspectives from psychoneuroimmunology. Annual Review of Psychology 53: 83107.
Kirsch, I, Sapirstein, G (1998) Listening to Prozac but hearing placebo: a meta-analysis of antidepressant medication. Prevention & Treatment 1(2): 117.
Kirsch, I (2005) Placebo psychotherapy: synonym or oxymoron? Journal of Clinical Psychology 61: 791803.
Kirsch, I, Deacon, BJ, Huedo-Medina, TB et al (2008) Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLOS Medicine 5 (2): e45.
Landin, R, Debrota, DJ, Devries, TA et al (2000) The impact of restrictive entry criterion during the placebo lead-in period. Biometrics 56: 271–8.
Lidstone, SC, Schulzer, M, Dinelle, K et al (2010) Effects of expectation on placebo-induced dopamine release in Parkinson disease. Archives of General Psychiatry 67: 857–65.
Luborsky, L, Diguer, L, Seligman, DA (1999) The researcher's own allegiances: ‘wild’ card in comparison of treatment efficacy. Clinical Psychology: Science and Practice 6: 95106.
Malan, DH (2001) Individual Psychotherapy and the Science of Psychodynamics (2nd edn). Arnold.
McAllister-Williams, RH (2008) Do antidepressants work? A commentary on ‘Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration’ by Kirsch et al. Evidence Based Mental Health 11: 66–8.
McKay, KM, Imel, ZE, Wampold, BE (2006) Psychiatrist effects in the psychopharmacological treatment of depression. Journal of Affective Disorder 92: 287–90.
McQueen, D, Cohen, S, St John-Smith, P et al (2013) Rethinking placebo in psychiatry: how and why placebo effects occur. Advances in Psychiatric Treatment 19: 171180.
Meissner, K, Distel, H, Mitzdorf, U (2007) Evidence For placebo effects on physical but not on biochemical outcome parameters: a review of clinical trials. BMC Medicine 5: 3.
Meissner, K, Kohls, N, Colloca, L (2011) Introduction to placebo effects in medicine: mechanisms and clinical implications. Philosophical Transactions of the Royal Society B: Biological Sciences 366: 1783–9.
Miller, FG, Colloca, L, Kaptchuk, TJ (2009) The placebo effect: illness and interpersonal healing. Perspectives in Biology and Medicine 52: 518–39.
Moerman, DE, Jonas, WB (2002) Deconstructing the placebo effect and finding the meaning response. Annals of Internal Medicine 136: 471–6.
Naylor, C, Galea, A, Parsonage, M et al (2012) Long-Term Conditions and Mental Health: The Cost of Co-Morbidities. King's Fund/Centre for Mental Health.
Newman, DH (2008) Hippocrates' Shadow. Scribner.
Nitzan, U, Lichtenberg, P (2004) Questionnaire survey on use of placebo. BMJ 329: 944–6.
Nunn, R (2009) It's time to put the placebo out of its misery. BMJ 338: 1015.
Papakostas, YG, Daras, MD (2001) Placebos, placebo effect, and the response to the healing situation: the evolution of a concept. Epilepsia 42: 1614–25.
Price, DD, Finniss, DG, Benedetti, F (2008) A comprehensive review of the placebo effect: recent advances and current thought. Annual Review of Psychology 59: 565–90.
Quitkin, FM, Rabkin, JG, Stewart, JW et al (1991) Heterogeneity of clinical response during placebo treatment. American Journal of Psychiatry 148: 193–6.
Rampes, HPK, Pilkington, K (2009) Complementary and alternative therapies. In The Art and Science of Mental Health Nursing: A Textbook of Principles and Practice (2nd edn) (ed Norman, I, Ryrie, I) 371–97. Open University Press.
Shorter, E (2011) A brief history of placebos and clinical trials in psychiatry. Canadian Journal of Psychiatry 56: 193–7.
Thompson, JJ, Ritenbaugh, C, Nichter, M (2010) Reconsidering the placebo response from a broad anthropological perspective. Culture, Medicine and Psychiatry 33: 112–52.
Thomson, R (1982) Side effects and placebo amplification. British Journal of Psychiatry 140: 64–8.
Tilburt, JC, Emanuel, EJ, Kaptchuk, TJ et al (2008) Prescribing ‘placebo treatments’: results of national survey of US internists and rheumatologists. BMJ 337: a1938.
Vase, L, Riley, JL 3rd, Price, DD (2002) A comparison of placebo effects in clinical analgesic trials versus studies of placebo analgesia. Pain 99: 443–52.
Wampold, BE, Minami, T, Tierney, SC et al (2005) The placebo is powerful: estimating placebo effects in medicine and psychotherapy from randomized clinical trials. Journal of Clinical Psychology 61: 835–54.
Wilkins, W (1984) Psychotherapy: the powerful placebo. Journal of Consulting and Clinical Psychology 52: 570–3.
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Rethinking placebo in psychiatry: the range of placebo effects

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