Experiencing COVID-19 symptoms without the disease: The role of nocebo in reporting of symptoms

Background: A nocebo effect occurs when inactive factors lead to worsening of symptoms or reduce treatment outcomes. Believing that one is or has been infected with COVID-19 may act as a nocebo. However, not much is known about potential nocebo effects associated with the reporting of COVID-19 sympt...

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Bibliographic Details
Published in:Scandinavian journal of public health 2022-02, Vol.50 (1), p.61-69
Main Authors: Daniali, Hojjat, Flaten, Magne Arve
Format: Article
Language:English
Subjects:
Aged
Anxiety - epidemiology
Anxiety Disorders
COVID-19
Female
Humans
Male
Nocebo Effect
Original
SARS-CoV-2
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Summary:Background: A nocebo effect occurs when inactive factors lead to worsening of symptoms or reduce treatment outcomes. Believing that one is or has been infected with COVID-19 may act as a nocebo. However, not much is known about potential nocebo effects associated with the reporting of COVID-19 symptoms. Aim: An online survey investigated whether certainty of being infected with COVID-19, age, sex, cognitive, emotional and personality factors were associated with perceived severity of COVID-19 symptoms. Methods: Participants (N=375) filled out an online survey containing 57 questions asking about symptoms resembling COVID-19, certainty of being infected with COVID-19, anxiety, stress and personality dimensions. Results: Certainty of being infected with COVID-19 and anxiety predicted 27% of the variance in reporting of COVID-like symptoms. The mediation analysis showed that both higher certainty of being infected and anxiety independently predicted increased reports of COVID-like symptom. Females had higher anxiety and stress levels, and reported more COVID-like symptoms than males did. Older age was not associated with reporting COVID-like symptoms. Conclusions: Believing to be infected with COVID-19, along with anxiety, can enhance the severity of COVID-like symptoms. Thus, the nocebo effect was due to both cognitive and emotional factors and was higher in females.
ISSN:1403-4948
1651-1905
DOI:10.1177/14034948211018385