> We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient-reported outcomes, especially pain and nausea, though it is difficult to distinguish patient-reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed.
"Nevertheless, it is important to mention that according to an influential 2001 meta-analysis comparing placebo-treatment arms with no treatment, placebos make no clinical difference.[20] However, the methodological difficulties of combining diverse conditions in a single meta-analysis are serious, and the authors’ updated meta-analysis includes more nuanced conclusions.[21] Furthermore, the meta-analyses implicitly assume the biological reductionist definition of placebo, ignoring the psychosocial context of sickness and health. The subjects in those studies were entered into a research programme and received attention and care. Therefore, in the way that the studies of the meta-analysis were actually conducted, there was plenty of room for the placebo effect without the placebo, which would spuriously suggest that the placebo was no more effective than no treatment, though in fact both had the potential to produce a placebo effect."
Interesting two part article by a Harvard Med School professor on whether psychiatric meds rely on an "activated placebo effect" (i.e. a placebo with side effects). Some would argue this isn't necessarily a bad thing as long as they are perceived to be efficacious by those taking them.
Yes. For instance, the person with $300 speaker cables feels good about how they sound and that puts them into a good mood. This is a physical benefit.
Psychological is physical. For instance we can measure things like dopamine levels in the brain related to mood. Psychological outlook is relevant to physical well-being.
There is a distinction, though it's tricky to word. It's about what is a direct effect, and what is an indirect effect.
There is a feedback loop between abstract thoughts and effects on the body, so to make a proper distinction you want to ignore the feedback loop and look at where the inputs are.
A placebo's direct effect is not physical. The direct effect is that first thought that you are receiving treatment, before it even has a chance to affect your mood.
A kidney transplant's direct effect is mostly physical. It's filtering your blood at a rapid pace.
So technically mood has physical effects but by the time you reach that stage you've destroyed the meaning of the term "physical benefit" into meaning just "benefit". Feel free to suggest better terms, but please don't muddle the waters.
I didn't say that. I believe that there are psychological benefits that have physical implications, and physical effects with psychological implications… As in depression can result in physical pain, and chronic pain can result in depression.
We don't even have ways in English (probably any language) to speak about internal states without resorting to dualism. The closest we can get is hardware/software analogies.
Jokes about homeopathy aside, if you can answer your own question, there's probably a Nobel prize in it for you. Mind/body interactions are incredibly complex and as yet pretty poorly understood.
There are some known ways to take advantage of similar effects--for instance, helping patients find ways to lower stress as a means of mitigating risk factors like high blood pressure.
Same here in the US, they even put them in the pharmacy :(
I remember one time I needed eyedrops. They were only listed as homeopathic in tiny print and were adjacent to real eyedrops in the pharmacy, so it was a bit hard to read them with my allergies going.
And I've tried washing my eyes with water, but it's not as effective as real eyedrops. Moreover, these contained "aspis", allegedly some extract from bees, which I might be allergic to. One would hope that they'd diluted it enough, but it actually listed a fairly low dilution factor so I couldn't even be sure the damned things weren't harmful.
Right now they don't have a clue. In my world, the effect
is the only existence of God--until proven differently. So
believing strongly in something isn't as foolish as some
"Intellectuals" would berate?
On a more serious note, medicine has a general problem dealing with the mind. The "placebo effect" is just one case where this manifests itself, but in case of drugs at least this effect can be scientifically measured.
In case of psychosomatic ilnesses (e.g. ilnesses which manifest with real symptoms, but the underlying cause is in the mind) it is much harder to quantify anything. How do you create a control group, if each person is so different? There is no way to "look inside the mind", no universal way to influence the mind.
Having gone through several ilnesses which (as I later discovered) were psychosomatic, I know the issue first-hand. Doctors tend to avoid even considering the mind's role, just as if we were simple machines, with the mind completely separate. On one hand this annoys me, on the other hand I understand them: a doctor is supposed to deal only with what is measurable and quantifiable. Cause and effect should both be measurable.
I've noticed that the number of articles about placebo effects, mind-caused ilnesses and psychosomatic problems in general seems to be increasing. I'm glad this is happening, as we definitely need more research done on these kinds of problems and we need to find ways to deal with them. From what I can see around me (now that I know about psychosomatic illnesses), many people suffer from them, and only deal with the symptoms.
I assume you mean this as a joke, but homeopathic remedies are so popular here in Germany -- the pharmacy shelves are loaded with them!! -- that I wonder whether use of the placebo effect is an official component of the national healthcare strategy.
Yeah, it's extremely weird to see homeopathic "medicine" all over in a country with an otherwise excellent, modern medical system.
Germany generally does a good job on evidence-based herbal medicine (like standardizing St. John's wort extract), but I worry that the line can easily be blurred between them and homeopathic products in the eyes of most consumers. You really have to look carefully - they're not clearly marked.
So honestly, you're probably quite right about it being a deliberate exploitation of the placebo effect. Because otherwise, there's no reason not to ban them.
No kidding. I went to the doctor with sleeping problems one time and he suggested I look up a certain drug. He said I couldn't get a prescription for it and it was to be taken therapeutically (i.e. indefinitely) and at the normal dosage it would cost something like 50 bucks a month.
I went home and looked it up: a homeopathic panacea with only a single "study". Not double blind, not even single blind -- they literally just gave the drug to some participants and the self-reported symptoms "improved".
I'm still not sure whether the GP was just trolling me.
> We did not find that placebo interventions have important clinical effects in general. However, in certain settings placebo interventions can influence patient-reported outcomes, especially pain and nausea, though it is difficult to distinguish patient-reported effects of placebo from biased reporting. The effect on pain varied, even among trials with low risk of bias, from negligible to clinically important. Variations in the effect of placebo were partly explained by variations in how trials were conducted and how patients were informed.