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The nocebo effect and its relevance for clinical practice.

机译:Nocebo效应及其与临床实践的关系。

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摘要

Negative expectations deriving from the clinical encounter can produce negative outcomes, known as nocebo effects. Specifically, research on the nocebo effect indicates that information disclosure about potential side effects can itself contribute to producing adverse effects. Neurobiological processes play a role in the nocebo effect, and this article provides a selective review of mechanistic research on the nocebo effect. Comparatively little attention has been directed to clinical studies and their implications for daily clinical practice. The nocebo response is influenced by the content and the way information is presented to patients in clinical trials in both the placebo and active treatment conditions. Nocebo effects adversely influence quality of life and therapy adherence, emphasizing the need for minimizing these responses to the extent possible. Evidence further indicates that the informed consent process in clinical trials may induce nocebo effects. This article concludes with ethical directions for future patient-oriented research and routine practice.
机译:从临床遭遇中获得的负面期望会产生负面结果,称为nocebo效应。具体而言,对Nocebo效应的研究表明,有关潜在副作用的信息披露本身可有助于产生不利影响。神经生物学过程在nocebo效应中起作用,本文提供了对nocebo效应机理研究的选择性综述。相对较少的注意力集中在临床研究及其对日常临床实践的影响上。在安慰剂和积极治疗条件下,nocebo反应均受临床试验中内容和信息呈递给患者的方式的影响。 Nocebo效应对生活质量和治疗依从性产生不利影响,强调需要尽可能减少这些反应。证据还表明,临床试验中的知情同意过程可能会诱发Nocebo效应。本文以伦理指导作为对未来以患者为中心的研究和常规实践的总结。

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