Thursday, April 26, 2007

The Nocebo Effect: Placebo's Evil Twin

By Brian Reid
Source: Washington Post

Ten years ago, researchers stumbled onto a striking finding: Women who believed that they were prone to heart disease were nearly four times as likely to die as women with similar risk factors who didn't hold such fatalistic views.

The higher risk of death, in other words, had nothing to with the usual heart disease culprits -- age, blood pressure, cholesterol, weight. Instead, it tracked closely with belief. Think sick, be sick.

That study is a classic in the annals of research on the "nocebo" phenomenon, the evil twin of the placebo effect.

While the placebo effect refers to health benefits produced by a treatment that should have no effect, patients experiencing the nocebo effect experience the opposite. They presume the worst, health-wise, and that's just what they get.

"They're convinced that something is going to go wrong, and it's a self-fulfilling prophecy," said Arthur Barsky, a psychiatrist at Boston's Brigham and Women's Hospital who published an article earlier this year in the Journal of the American Medical Association beseeching his peers to pay closer attention to the nocebo effect. "From a clinical point of view, this is by no means peripheral or irrelevant."


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