Victor Chavarria|João Vian|Círia Pereira|João Data-Franco|Brisa S. Fernandes|Michael Berk|Seetal Dodd
The Placebo and Nocebo Phenomena: Their Clinical Management and Impact on Treatment Outcomes
Parc de Salut|University of Lisbon|Centro Hospitalar Lisboa Norte|University of Lisbon|Centro Hospitalar Lisboa Norte|Hospital Beatriz Ângelo|University of Lisbon|Deakin University|Universidade Federal do Rio Grande do Sul|University of Melbourne|Deakin University|Barwon Health|Geelong Hospital|Florey Institute of Neuroscience and Mental Health|Barwon Health|Geelong Hospital|Deakin University|University of Melbourne
overview focuses placebo nocebo effects clinical trials routine care goal propose strategies improve outcomes clinical practice maximizing placebo effects reducing nocebo effects well managing phenomena clinical trialsa narrative literature search pubmed conducted january 1980september 2016 systematic reviews randomized controlled trials observational studies case series emphasis placebo nocebo effects clinical practice included qualitative synthesis search terms included placebo nocebo clinical clinical trial clinical setting placebo effect nocebo effect adverse effects treatment outcomes search augmented manual search references key articles related literatureplacebo nocebo effects psychobiological events imputable therapeutic context placebo defined inert substance provokes perceived benefits whereas term nocebo used inert substance causes perceived harm major mechanisms expectancy classical conditioning placebo used several fields medicine diagnostic tool reduce drug dosage placebonocebo effects difficult disentangle natural course illness actual effects new drug clinical trial known strategies enhance clinical results manipulating expectations conditioningplacebo nocebo effects occur frequently clinically significant underrecognized clinical practice physicians able recognize phenomena master tactics manage effects enhance quality clinical practice