Role of placebo effects in pain and neuropsychiatric disorders

• Published in: Progress in neuro-psychopharmacology & biological psychiatry 2018-12, Vol.87 (Pt B), p.298-306
• Main Authors: Belcher, Annabelle M., Ferré, Sergi, Martinez, Pedro E., Colloca, Luana
• Format: Article
• Language: English
• Subjects: Expectancy; Humans; Mental Disorders - psychology; Mental Disorders - therapy; Nocebo effect; Pain - psychology; Pain Management; Pharmacological and context-dependent conditioning; Placebo Effect; Social observational; Verbal suggestion
• ISSN: 0278-5846; 1878-4216; 1878-4216
• DOI: 10.1016/j.pnpbp.2017.06.003

The placebo (and the nocebo) effect is a powerful determinant of health outcomes in clinical disease treatment and management. Efforts to completely eradicate placebo effects have shifted dynamically, as increasingly more researchers are tuned to the potentially beneficial effects of incorporating those uncontrollable placebo effects into clinical therapeutic strategies. In this review, we highlight the major findings from placebo research, elucidating the main neurobiological systems and candidate determinants of the placebo phenomenon, and illustrate a perspective that can effectively frame future research on the topic. Finally, we issue a call for increased research on the efficacy of therapeutic strategies that incorporate placebo “tools,” and argue that clinical trials of the placebo response in neuropsychiatric diseases and disorders has important and far-reaching translational and clinical relevance. •Placebo and nocebo effects can be elicited by verbal, conditioned and social cues•Placebo/nocebo expression strength is dependent on multiple neurobiological and genetic determinants, subject to individual differences•Ways in which to harness therapeutic placebo effects to treat chronic pain and neuropsychiatric disorders is increasingly appreciated