Nocebo effects can make you feel pain
Abstract
The mysterious phenomenon known as the nocebo effect describes negative expectancies. This is in contrast to positive expectancies that trigger placebo effects (1). In evolutionary terms, nocebo and placebo effects coexist to favor perceptual mechanisms that anticipate threat and dangerous events (nocebo effects) and promote appetitive and safety behaviors (placebo effects). In randomized placebo-controlled clinical trials, patients that receive placebos often report side effects (nocebos) that are similar to those experienced by patients that receive the investigational treatment (2). Information provided during the informed consent process and divulgence of adverse effects contribute to nocebo effects in clinical trials (1). Nocebo (and placebo) effects engage a complex set of neural circuits in the central nervous system that modulate the perception of touch, pressure, pain, and temperature (1, 3, 4). Commercial features of drugs such as price and labeling influence placebos (5, 6). On page 105 of this issue, Tinnermann et al. (7) show that price also influences nocebo effects.
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References and Notes
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S. Kam-Hansen et al., Sci. Transl. Med. 6, 218ra5 (2014).
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A. Tinnermann et al., Science 358, 105 (2017).
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U. Bingel et al., Sci. Transl. Med. 3, 70ra14 (2011).
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L. Colloca, D. Finniss, JAMA 307, 567 (2012).
Information & Authors
Information
Published In
Science
Volume 358 | Issue 6359
6 October 2017
6 October 2017
Copyright
Copyright © 2017, American Association for the Advancement of Science.
This is an article distributed under the terms of the Science Journals Default License.
Submission history
Received: 10 September 2017
Published in print: 6 October 2017
Acknowledgments
This research is funded by the U.S. National Institutes of Health (NIDCR, R01DE025946, L.C.).
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