ArticleThe Journal of clinical psychiatry2014
The role of patient expectancy in placebo and nocebo effects in antidepressant trials.
Article in The Journal of clinical psychiatry, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Nocebo effects in systemic therapies for adult plaque psoriasis: A systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- Placebo Response in Rheumatoid Arthritis Clinical Trials.The Journal of rheumatology · 2020Pooled it
- Pharmacological Treatment of ADHD in Addicted Patients: What Does the Literature Tell Us?Harvard review of psychiatryPooled it
- A pilot randomized controlled trial of hearing aids to improve mood and cognition in older adults.International journal of geriatric psychiatry · 2020Trial
- Changes in typical beliefs in response to complicated grief treatment.Depression and anxiety · 2020Trial
- Specific expectancies are associated with symptomatic outcomes and side effect burden in a trial of chamomile extract for generalized anxiety disorder.Journal of psychiatric research · 2017Trial
- Antidepressant treatment history and drug-placebo separation in a placebo-controlled trial in major depressive disorder.Psychopharmacology · 2015Trial
- Neuroimaging as a Tool for Advancing Pediatric Psychopharmacology.Paediatric drugs · 2025Review
- Exploratory study of nocebo effect in senior medical students.Health psychology research · 2024Article
- Randomized trial of ketamine masked by surgical anesthesia in patients with depression.Nature. Mental health · 2023Article
- The Importance of Patient Expectations: A Mixed-Methods Study of U.S. Psychiatrists.Frontiers in psychiatry · 2021Article
- The evidence-based group-level symptom-reduction model as the organizing principle for mental health care: time for change?World psychiatry : official journal of the World Psychiatric Association (WPA) · 2019Article
- Significance of Participants' Expectations in Managing the Placebo Effect in Antidepressant Research.Frontiers in psychiatry · 2019Article
- Ethical considerations in placebo-controlled randomised clinical trials.BJPsych open · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
objectiveTo determine whether patient expectancy plays a role in observed placebo and nocebo effects in 2 clinical trials.
methodData were reanalyzed from 2 fluoxetine-discontinuation studies conducted from March 1990 to September 1992 and from May 1997 to December 2002. The 673 outpatients included were aged 18-65 years with DSM-III-R major depressive disorder (MDD), responded to 12-week duration open treatment, and were randomized to continued fluoxetine or placebo for an additional year. Participants in 1 of the included studies received a fixed dose of fluoxetine 20 mg daily, while the second study utilized flexible fluoxetine doses up to 60 mg daily. Mixed effects longitudinal models determined whether the possible randomization to placebo at 12 weeks resulted in significant depressive symptom worsening across treatments. Correlations were computed between early symptom change (weeks 1-3 of open treatment) and postrandomization symptom change (weeks 13-16 following randomization).
resultsParticipants continuing to receive fluoxetine and those switched to placebo had significantly higher mean Hamilton Depression Rating Scale (HDRS) scores immediately postrandomization compared to the final weeks of open treatment (P < .001 for both fluoxetine- and placebo-treated patients). In both studies, early HDRS change was significantly correlated with postrandomization HDRS change for patients receiving fluoxetine (r = -0.46, P < .001) as well as placebo (r = -0.48, P < .001).
conclusionsThe possibility of receiving placebo following 12 weeks of open fluoxetine was associated with significant symptom worsening in 2 large fluoxetine discontinuation studies. Worsening depression scores following randomization were significantly associated with the degree of improvement participants experienced during weeks 1-3 of open treatment. These results suggest that treatment changes influence patients' expectations of improvement, which, in turn, affect their depressive symptoms.
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