Thinking yourself sick
Every day, many of us take clinically proven drugs that fail to work as plannedor that trigger unexplained side-effects.
The reasons for this can be chemically complex, but new research suggests that there may also be a far simpler explanation: we think that they are having a bad effect.
It
is called the nocebo effect, and it’s the dark side of the well-known placebo effect, when a patient’s health improves because he or she believes that a treatment is going to make them better. The nocebo effect can worsen symptoms, exacerbate side-effects and can render drugs less effective. In other words, expectation of sickness begets sickness.
There are a lot of pessimistic patients: one report suggests that more than a quarter of us may experience the nocebo effect when we take a drug. Researchers from the Cardarelli Hospital, Naples, say in the Journal of Investigational Allergology and Clinical Immunology: “Our data, collected in a large population, confirm that the nocebo effect occurs frequently in clinical practice.”
UK doctors agree. “We think that it is a relatively common phenomenon,” says David Blake, Professor of Joint and Bone Medicine at the Royal National Hospital for Rheumatic Diseases, Bath, who has written on the subject.
Negative verbal suggestions might trigger anxiety about an impending increase in pain.
There is no doubt that emotions play a significant role, too. Dr Brian Olshansky, who reported earlier this year on nocebo in the Journal of the American College of Cardiology, says that patients who are anxious or depressed are more prone to suffer. So, too, are patients who are specifically asked if they are suffering adverse effects, which can send nocebo spiralling as high as 71 per cent.
Mind over matter
A 2004 study suggested that one patient in six seen by a GP may have some form of psychosomatic illness, when physical symptoms such as stomach pains, headaches or fatigue have no medical reason and are caused by mental factors, such as anxiety and depression.
Some diseases are thought to be particularly prone to mental factors. These include psoriasis, eczema, stomach ulcers and irritable bowel syndrome.
From the Times. UK
http://www.timesonline.co.uk/tol/lif...cle2321071.ece