Placebo and nocebo phenomena from the perspective of evidence based and person centered medicine

Abstract

SUMMARYIntroduction: Placebo and nocebo phenomena in pharmacology are very important, but controversial issues from the perspective of evidence-based medicine (EBM) in many ways. Topic: Glorifi cation and vilifi cation of placebo controlled studies are the two opposite sides of the prevailing misunderstanding placebo and nocebo phenomena in medicine and pharmacology. This misunderstanding is an essential component of the pseudoscientifi c evaluation and evidence-based medicine. The using of placebo and avoidance of nocebo responses have been recommended as promising additional clinical strategies. The aim and purpose of this paper is to give a transdisciplinary and integrative overview of the placebo and nocebo from the perspective of person-centered medicine and also to provide some practical tips on how to increase placebo and decrease nocebo response in clinical practice. Conclusions: Confl icting data from clinical trials and misunderstanding of placebo and nocebo phenomena are essential components of the contamination and confusion regarding evidence-based medicine. Person-centered clinical pharmacology is partly about taking advantage of placebo and avoiding of nocebo phenomena in a clinical setting as additive eff ects to improve the eff ectiveness of the standard medication.

Incidence and characteristics of the nocebo response from meta‐analyses of the placebo arms of clinical trials of olanzapine for bipolar disorder

“…Elsewhere, participant characteristics including neuroticism, pessimism and type A personalities have been associated with nocebo response . Understanding the propensity of an individual to have a nocebo response may be useful from a perspective of person‐centred medicine, where it can be addressed on an individualized basis …”

“…1 Understanding the propensity of an individual to have a nocebo response may be useful from a perspective of personcentred medicine, where it can be addressed on an individualized basis. 9 In addition, prior experiences may also increase the risk of a nocebo response. Prior adverse events or dissatisfaction with medical services may cause negative expectations.…”

RESILIENCE, PSYCHIATRY AND RELIGION FROM PUBLIC AND GLOBAL MENTAL HEALTH PERSPECTIVE Dialogue and Cooperation in the Search for Humanistic Self, Compassionate Society and Empathic Civilization

“…Spirituality and religiosity may act as resilience resources to manage adversity (Reutter & Bigatti 2014). Placebo response may be an expression of psychological and spiritual resilience (Jakovljevic 2017b).…”