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| The Nocebo Effect https://thesymmetryforum.com/viewtopic.php?f=24&t=110 |
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| Author: | themsforum.org [ Fri, 26 Oct 2012, 7:11 pm ] |
| Post subject: | The Nocebo Effect |
The Nocebo Effect Posted: 25 Oct 2012 05:30 PM PDT Epub: Data-Franco & Berk. The nocebo effect: A clinicians guide. Aust N Z J Psychiatry. 2012 Oct 23. This paper aimed to provide an overview on the nocebo effect and evidence-based strategies for management and minimisation of the nocebo effect. The nocebo effect refers to non-pharmacodynamic, harmful or undesirable effects occurring after inactive [ineffective] treatment, a phenomenon that also occurs in the context of active therapy. Known drivers include classical conditioning and negative expectations concerning treatment. Recent meta-analyses have reported a considerable prevalence, ranging from 18% in the symptomatic treatment of migraine, to more than 74% in multiple sclerosis. Recognition of the nocebo-driven adverse effects presents a challenge, especially because of its non-specific nature and the similarity to the active medication's expected profile. Traits such as neuroticism, pessimism and type A personalities may predispose individuals to this phenomenon. Clinical management of the nocebo effect includes awareness and recognition, changing the manner of disclosure of potential drug-related adverse effects, shaping patients' expectations and enhancing the treatment alliance. It is concluded that the nocebo effect is a common, clinically significant, yet covert driver of clinical outcomes. Increased awareness of its features, as well as knowledge of strategies on how to manage it, are fundamental so that clinicians can mitigate its impact on clinical practice. "The nocebo response refers to harmful, unpleasant, or undesirable effects a person manifests after receiving a dummy drug or placebo. Nocebo responses are not chemically generated and are due only to the subject's pessimistic belief and expectation that the inert drug will produce negative consequences." "In these cases, there is no 'real' drug involved, but the actual negative consequences of the administration of the inert drug, which may be physiological, behavioural, emotional, and/or cognitive, are nonetheless real." Comment: This is a phenomenal finding. It introduces a chance from 18% to 74% of an effect which is unreal whether the drug is a sugar pill or a real drug. It puts into serious doubt when claims of slight positive effects of any drug therapy are made! © 2012 M. Amir All rights reserved Challenging the existing standards in dental and medical care comes with significant costs. Through my website and this forum, I have highlighted practices that, whether intentionally or unintentionally, contribute to ongoing illness. This disruption is not welcomed by the authorities overseeing our healthcare system. To continue publishing evidence-based articles, sharing discoveries from my own patients' experiences that have led to their recoveries through a unique approach, and educating thousands of health professionals and patients globally, we require some support. If this article has substantially enhanced your understanding, please consider making a donation through this link: PLEASE CLICK TO DONATE Thank you! A heartfelt thank you to everyone who has generously contributed. Your support is deeply valued and enables Dr. Amir to persist in his mission of fostering improved dental and medical practices globally. ------------------------------------------------------------------------------------------NOTICE----------------------------------------------------------------------------------------------- This article is written in accordance with the Human Rights Act 1998: UK Public General Acts 1998 c. 42 SCHEDULE 1 PART I Article 10, with the intent of serving the resilient British public. This legislation clearly states, Everyone has the right to freedom of expression. This right shall include freedom to hold opinions and to receive and impart information and ideas without interference by public authority. We are committed to addressing any form of harassment, whether direct or indirect, by government bodies or their affiliates, in line with this act and the principles that protect freedom of expression. Additionally, any breaches of the Data Protection Act will be promptly reported to the Information Commissioner's Office and The Law Society .................................................................................................................................................................................................................................. Disclaimer: This educational article focuses on health benefits from individual perspectives and doesn't imply widespread results. Important to seek a doctor's advice before taking action. It's meant to enhance, not substitute for, medical advice and doesn't detail all possible uses or risks. Always prioritize professional medical advice over information read here. |
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