Do you know the "placebo effect"?

* By Randy Dotinga

Researchers of the "placebo effect" say that doctors need to learn to better exploit the power of words for the benefit of their patients,,,Auto suggestion: the placebo effect causes the person to experience symptoms just by having read or heard about them

Some people feel better after taking a medicine, even if that medicine does absolutely nothing to treat the disease or condition that has raised the demand for health services. It's called the "placebo effect."

There is, however, a lesser known side of the power of suggestion: when a person develops symptoms or the side effects of drug or responds to a treatment simply because they have read or heard about it, this is a phenomenon known as the "placebo effect".

A new study examined the "placebo effect" and suggests that physicians learn the best way to explore the "power of words" for the benefit of their patients.

"Not only is the power of negative words - mostly unintentionally said - from doctors and nurses that count, but also the power of fears and negative experiences and expectations of the patients themselves," says Winfried Hauser, study author and associate professor of psychosomatic medicine at Klinikum Saarbrucken, Germany.

The study, published recently in the journal Deutsches Arzteblatt International, analyzed various research on the placebo effect and found that scientists and doctors spent very little time trying to understand it. About 2,200 studies examined the placebo effect, but only a few dozen further explored the placebo effect.

In one study, the researchers randomly divided 50 patients with chronic back pain into into two groups: one of them was told that a test of knee flexion could increase some of the pain they felt. The others were told the exercise would not affect the pain in their back.  Those who were warned about the pain reported feeling more pain and did not perform as well as those who were not warned.

The research also showed that people who thought they had received a drug could develop the side effects of the drug without it actually being administered. What doctors and nurses say can also affect patients negatively.

"Patients are highly receptive to negative suggestion, particularly in situations perceived as existentially threatening such as imminent surgery, serious acute illness or an accident," the researchers wrote.

"Often, people in extreme situations are in a natural state of trance and therefore highly suggestible. This state of consciousness leaves them susceptible to misunderstandings arising from literal interpretations, ambiguity and negative suggestion."

Members of the medical team can trigger problems, emphasizing the negative ("you are a high-risk patient") being uncertain ("this medicine may help"), focusing attention on conditions such as pain and nausea ("let us know if you feel pain ") and trivializing the situation experienced by the patient (" you need not worry "), the study noted.

Researchers are still trying to figure out what kind of people are more susceptible to suggestion and why. So what can be done?

Hauser said that doctors and nurses should receive training in how to communicate better with patients to avoid instilling negative suggestions. Hauser also made a suggestion with ethical implications: patients may not need so much information about all the bad things that can happen to them.

"You have to consider reducing the amount of negative information given to patients about potential effects, as well as details of prescriptions," Hauser argues.

Ted Kaptchuk, an associate professor at Harvard Medical School (USA), who studies the placebo effect, praised the study, but said the suggestions about providing less information raises ethical issues.

"If we do not inform patients of adverse effects, besides being unethical and lacking in transparency, we are not providing the possibility of full informed consent," he argues.

"On the other hand, if we tell everything to everyone, it really can produce damage. This is a key issue in health care: honesty versus harm."

But what can patients themselves do about the placebo effect?

"They should be aware of the power of their expectations and beliefs in a medical treatment," Hauser suggests.

"If you decide to undergo a medical treatment, believe that it will work."

Translated from the Portuguese version by:

Lisa Karpova


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Author`s name Timothy Bancroft-Hinchey