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When western anthropologists first heard reports of witch doctors who could issue deadly curses, they quickly found rational explanations. The families of the cursed often felt there was no point wasting food on the "walking dead", for example. That's why many of the cursed would die: simple starvation.
However, other case histories have come to light that defy attempts to explain them. In the 1970s, for example, doctors diagnosed a man with end-stage liver cancer, and told him he had just a few months to live. Though the patient died in the predicted time, an autopsy showed the doctors had been mistaken. There was a tiny tumour, but it had not spread. It seemed the doctors' prognosis had been a death curse.
Though the mechanism remains a mystery, but at least now this kind of phenomenon has a name. The "nocebo effect" is the lesser-known opposite number of the placebo effect, and describes any case where putting someone in a negative frame of mind has an adverse effect on their health or well-being. Tell people a medical procedure will be extremely painful, for example, and they will experience more pain than if you had kept the bad news to yourself. Similarly, experiences of side effects within the placebo groups of drug trials have shown that a doctor's warning about the possible side effects of a medicine makes it much more likely that the patient will report experiencing those effects.
13 more things: The nocebo effect
It's possible that the nocebo response is easily explained: in the antidepressant trials, maybe some patients — given that they already tended toward depression and anxiety — worried so much about the doctor's cautions that their stomach released enough acids to cause pain. That would make sense except that the range of possible nocebo responses stretches far beyond stomachache (in extreme cases, ailing patients who are mistakenly informed that they have only a few months to live will die within their given time frame, even though postmortem investigations show that there was no physiological explanation for early death). In a new paper published in the journal Pain, researchers found that clinical-trial participants have reported a wide variety of nocebo-fueled medical complaints, including burning sensations outside the stomach, sleepiness, fatigue, vomiting, weakness and even taste disturbances, tinnitus and upper-respiratory-tract infection. What's more, these nocebo complaints aren't random; they tend to be specific to the type of drug that patients believe they may be taking. (Read "The Year in Medicine 2008: From A to Z.")
The Pain study, which was led by Italian neuroscientist Martina Amanzio, reviewed 73 clinical trials conducted between 1988 and 2007. All the previously published trials pitted potential antimigraine medications against sugar pills. The medications included nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil); triptans, which include Imitrex; and anticonvulsant drugs like Topamax. Those three categories of drugs carry different adverse effects: NSAIDs, for instance, often cause stomach problems; anticonvulsants can cause paresthesia (tingling) and memory impairment. Interestingly, patients who took sugar pills tended to report nocebo problems consistent with whatever drug they thought they might have swallowed. No one who thought they could be taking an NSAID or triptan reported memory problems or tingling, but some who thought they might have taken anticonvulsants did. Likewise, only placebo groups in the NSAID trials reported side effects like stomach upset and dry mouth.
The Flip Side of Placebos: The Nocebo Effect
The subject-expectancy effect, is a form of reactivity that occurs in scientific experiments or medical treatments when a research subject or patient expects a given result and therefore unconsciously affects the outcome, or reports the expected result. Because this effect can significantly bias the results of experiments (especially on human subjects), double-blind methodology is used to eliminate the effect.
Like the observer-expectancy effect, it is often a cause of "odd" results in many experiments. The subject-expectancy effect is most commonly found in medicine, where it can result in the subject experiencing the placebo effect or nocebo effect, depending on how the influence pans out.
An example of a scenario involving these various effects is as follows: A woman goes to her doctor with an issue. The doctor diagnoses with certainty, and then clearly explains the diagnosis and the expected route towards recovery. If he does this convincingly, calming her, removing fear and instilling hope, she will likely, through the positive expectancy, experience the placebo effect, aiding in her recovery. On the other hand, if her doctor had had little time for her, was uncertain about the diagnosis, and had given her a prescription, combined with a message along the lines of, "this may help sometimes," and added a message about possible horrible side effects (combined, say, with the patient having talked to a neighbor who also speaks along the same lines about the horrible side effects), then the chance of negative subject-expectancy, or nocebo, becomes quite large.
Subject-expectancy effect - Wikipedia
Not that I have any explanations. Just idly pointing at the problem.
and it's one of the reasons I am very, very VERY against graphic warnings on cigarette packages.