Lene Vase

The magnitude of nocebo effects in pain: A meta-analysis

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review

  • Gitte Laue Petersen, Danmark
  • Nanna Brix Finnerup
  • Luana Colloca, National Center for Complementary and Alternative Medicine (NCCAM), National Institute of Mental Health (NIMH), and Clinical Center, Department of Bioethics, National Institutes of Health, Bethesda, MD, USA.
  • ,
  • Martina Amanzio, Department of Psychology, University of Turin, National Institute of Neuroscience (INN) Turin, Italy.
  • ,
  • Donald D Price, Division of Neuroscience, Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, FL, USA.
  • ,
  • Troels Staehelin Jensen
  • Lene Vase

The investigation of nocebo effects is evolving and a few literature reviews have emerged, however, so far without quantifying such effects. This quantitative systematic review investigated nocebo effects in pain. We searched the databases PubMed, EMBASE, Scopus, and the Cochrane Controlled Trial Register with the term "nocebo". Only studies that investigated nocebo effects as the effects that follow the administration of an inert treatment along with verbal suggestions of symptom worsening and that included a no-treatment control condition were eligible. Ten studies fulfilled the selection criteria. The effect sizes were calculated using Cohen's d and Hedges' g. The overall magnitude of the nocebo effect was moderate to large (lowest g = 0.62 (0.24-1.01) and highest g = 1.03 (0.63-1.43)) and highly variable (range of g = -0.43-4.05). The magnitudes and range of effect sizes was similar to those of placebo effects (d = 0.81) in mechanistic studies. In studies where nocebo effects were induced by a combination of verbal suggestions and conditioning, the effect size was larger (lowest g = 0.76 (0.39-1.14) and highest g = 1.17 (0.52-1.81)) than in studies where nocebo effects were induced by verbal suggestions alone (lowest g = 0.64 (-0.25-1.53) and highest g = 0.87 (0.40-1.34)). These findings are similar to those in the placebo literature. Since the magnitude of the nocebo effect is variable and sometimes large, this systematic review demonstrates the importance of minimizing nocebo effects in clinical practice.

OriginalsprogEngelsk
TidsskriftPain
Vol/bind155
Nummer8
Sider (fra-til)1426-1434
ISSN0304-3959
DOI
StatusUdgivet - 2014

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