Placebos Plus Positive Thinking May Be Enough

Editor's Choice
Main Category: Psychology / Psychiatry
Also Included In: Primary Care / General Practice;  Irritable-Bowel Syndrome;  Public Health
Article Date: 23 Dec 2010 - 11:00 PDT

email to a friend   printer friendly   opinions  

Placebos, which contain no active ingredients, are typically used as controls for potential new medication clinical trials. It has been confirmed that patients often respond to them based solely on the idea that the act of taking a medication, coupled with a positive mental attitude, may in fact cause the body to heal itself or identify that the original diagnosis was self created .

Associate professor of medicine Ted Kaptchuk at Harvard Medical School says:

"These findings suggest that rather than mere positive thinking, there may be significant benefit to the very performance of medical ritual. I'm excited about studying this further. Placebo may work even if patients know it is a placebo."

Traditionally in medical research, placebos depend on the use of controlled and measured deception. It is estimated that currently 50 percent of all doctors in the United States administer placebos, or dummy pills, to their patients without them being aware of it. As questionable this practice may be, to most of us, the placebo effect is synonymous with the power of positive thinking. The action works because it fools the mind into believing it is taking true active medications.

The phenomenon of an inert substance resulting in a patient's medical improvement is called the placebo effect. The phenomenon is related to the perception and expectation which the patient has; if the substance is viewed as helpful, it can heal, but if it is viewed as harmful, it can cause negative effects, which is known as the nocebo effect.

However, what if patients knew they were taking a placebo? Would positive thinking be enough? Kaptchuk teamed up with colleagues at Beth Israel Deaconess Medical Center (BIDMC) to find out.

Eighty patients suffering from irritable bowel syndrome (IBS) were divided into two prescribed groups. The controls received no treatment. The second group received placebo cycles which were openly described as such. Subjects were told to take the pills twice per day.

Kaptchuk continues:

"Not only did we make it absolutely clear that these pills had no active ingredient and were made from inert substances, but we actually had 'placebo' printed on the bottle. We told the patients that they didn't have to even believe in the placebo effect. Just take the pills."

Three weeks passed and almost double of the patients treated with the placebo, 59 percent, reported symptom relief as compared to the control group which was only 39 percent. Additionally, patients taking the placebo increased their rates of improvement by double to a relief threshold achieved by some of the most powerful IBS medications on the market.

Senior study author Anthony Lembo, HMS associate professor of medicine at BIDMC and an expert on IBS stated:

"I didn't think it would work. I felt awkward asking patients to literally take a placebo. But to my surprise, it seemed to work for many of them."

The authors do make a point that this study was small compared to many investigative studies of this kind, but it does in fact open a dialogue about whether or not placebos are effective even for the fully informed patient. Such a hypothesis will need to be confirmed in larger trials hopefully on a much bigger international scale to take into consideration the differences and relations between traditional and holistic methods of treatment.

"Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome"
Ted J. Kaptchuk, Elizabeth Friedlander, John M. Kelley, M. Norma Sanchez, Efi Kokkotou, Joyce P. Singer, Magda Kowalczykowski, Franklin G. Miller, Irving Kirsch, Anthony J. Lembo
PLoS ONE 5(12): e15591. doi:10.1371/journal.pone.0015591

Written by Sy Kraft, B.A.
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations