What is the nocebo effect?

The nocebo effect refers to the situation in which a patient presents the possible side effects or symptoms that produces a drug or treatment just because you think they can happen.

From the psychological point of view, the nocebo effect implies the negative anticipation in the form of anxiety, fear, or revulsion to treatment. It could be said that human beings tend to perceive what they expect to perceive.

This effect will not only generate adverse effects, but will also affect the patient's adherence to treatment.

Placebo effect

The use of it can arouse ethical conflicts: administering an inert treatment without informing the patient, it is not the ideal procedure.

Although it is usually used in clinical practice in some cases, it has been described that sometimes tests not indicated are requested so that the patient feels “better cared for” or antibiotics are prescribed against viral diseases, for which they are absolutely ineffective.

Nocebo effect

It is thought that the nocebo effect can awaken fewer ethical dilemmas, since the intention of the physician should be to minimize it. The mechanism by which this effect is produced is not entirely clear, however, it is thought to be of origin multifactorial.

The nocebo effect is the result of a interaction between various factors: characteristics of the patient, the psychosocial context and neurobiological aspects, but the relationship with them and the way in which the information is provided and received must also be taken into account.

Among the factors related to the patient it has been found:

• The female sex,
• Pessimistic personality,
• Anxious-depressive pathology,
• Cultural beliefs,
• Doctor-pacient relationship,
• Verbal and non-verbal communication.

There's also psychological stimuli such as conditioning what it will taste like, the form, the color, the name of the medication, previous experiences, and expectations.

How useful can the nocebo effect be?

Knowing this effect can be useful in medical consultations since the doctor-patient relationship and communication of information on adverse effects de are an important and modifiable factor to avoid this effect.

Some studies have shown and quantified the nocebo effect produced in various everyday situations such as:

• Reading the drug leaflet
• The information administered to patients participating in a clinical trial about the possible adverse effects that they may present
• The appearance of news in the media about drug alerts.

Health professionals in general should be aware of the possibility of inducing a nocebo effect, unintentionally, in communication with the patient.

• The nocebo effect refers to the situation in which a patient exhibits the possible side effects or symptoms of a drug or treatment just because they believe they might occur.
• This effect will not only generate adverse effects, but will also affect the patient's adherence to treatment.
• Knowing this effect is useful in Medical consultations since the doctor-patient relationship and the communication of information on the adverse effects of medications are an important and modifiable factor in order to avoid this effect.

CALCULATE YOUR PRICE

Dra. Daniela M. Piñango Family Medicine Specialist