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A review of the theoretical and biological understanding of the nocebo and placebo phenomena

Dodd, Seetal, Dean, Olivia M., Vian, Joao and Berk, Michael 2017, A review of the theoretical and biological understanding of the nocebo and placebo phenomena, Clinical therapeutics, vol. 39, no. 3, pp. 469-476, doi: 10.1016/j.clinthera.2017.01.010.

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Title A review of the theoretical and biological understanding of the nocebo and placebo phenomena
Author(s) Dodd, Seetal
Dean, Olivia M.
Vian, Joao
Berk, Michael
Journal name Clinical therapeutics
Volume number 39
Issue number 3
Start page 469
End page 476
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2017-03
ISSN 0149-2918
1879-114X
Keyword(s) conditioning
dopamine
expectancy
nocebo
pharmacology
placebo
treatment
µ-opioid
Summary PURPOSE: Placebos are commonly used in experimental and patient populations and are known to influence treatment outcomes. The mechanism of action of placebos has been investigated by several researchers. This review investigates the current knowledge regarding the theoretical and biological underpinning of the nocebo and placebo phenomena.
METHOD: Literature was searched using PubMed using the following keywords: nocebo, placebo, μ-opioid, dopamine, conditioning, and expectancy. Relevant papers were selected for review by the authors.
FINDINGS: The roles of conditioning and expectancy, and characteristics associated with nocebo and placebo responses, are discussed. These factors affect nocebo and placebo responses, although their effect sizes vary greatly, depending on inter-individual differences and different experimental paradigms. The neurobiology of the nocebo and placebo phenomena is also reviewed, emphasizing the involvement of reward pathways, such as the μ-opioid and dopamine pathways. Neurobiological pathways have been investigated in a limited range of experimental paradigms, with the greatest efforts on experimental models of placebo analgesia. The interconnectedness of psychological and physiological drivers of nocebo and placebo responses is a core feature of these phenomena.
IMPLICATIONS: Further research is needed to fully understand the underpinnings of the nocebo and placebo phenomena. Neurobiology pathways need to be investigated in experimental paradigms that model the placebo response to a broader range of pathologies. Similarly, although many psychological factors and inter-individual characteristics have been identified as significant mediators and moderators of nocebo and placebo responses, the factors identified to date are unlikely to be exhaustive.
Language eng
DOI 10.1016/j.clinthera.2017.01.010
Field of Research 111502 Clinical Pharmacology and Therapeutics
1115 Pharmacology And Pharmaceutical Sciences
Socio Economic Objective 920199 Clinical Health (Organs
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, Esevier HS Journals, Inc.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30091352

Document type: Journal Article
Collection: School of Medicine
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