From the New York Magazine:
The Placebo Effect Is Getting Stronger — But Only in the U.S.
“It’s a mystery of modern medicine: Americans — and only Americans — are becoming more likely to report feeling very real physical effects after taking totally fake painkillers, say scientists from McGill University. According to their findings, published this week in the journal Pain, the placebo effect has gotten stronger since the early 1990s, but only in drug trials conducted within the U.S. — not ones conducted in Europe or Asia.
The researchers have zeroed in on two potential explanations.
First, the U.S. is one of only two countries worldwide in which drug companies are allowed to advertise directly to consumers. (The other is New Zealand.)
But the more important answer, the researchers think, may lie in the fact that clinical trials in the U.S. grew longer and included more participants over the two decades studied here… And as these trials have grown, they’ve added more non-pharmaceutical aspects, such as hiring nurses to consult with the trial participants, Jeffrey Mogil, who led the study, told Nature. All of these factors may infuse the entire experience with an official, legitimized kind of feeling, which may also be contributing to the rise in placebo effectiveness.” (emphasis added)
Here’s an interesting, ethical question, if advertising drugs makes them more effective, should it be allowed more, even encouraged?
Johnsen and Friborg (2015) have shown in a meta analysis that CBT is now half as successful at treating depression as it was 38 years ago.They query whether the placebo effect is at play,with people initially believing it was a panacea for all our psychological needs.
I feel memetics may be playing a part in both these scenarios.I also think manual therapists movement toward the BPS approach is a social meme.
It has been shown that people who read the side effects of medications are far more likely to suffer from them -the nocebo effect
I often avoid placebo discussions – you can’t please everyone! Neil O’Connell has written very succinctly about placebo in relation to this paper over at BIM.
But to Tim’s question about advertising making drugs more effective , its not too much of a jump to suggest that advertising one’s rehab service could make it more effective …’internationally trained therapists with silky smooth hands skilled at listening to YOUR problem, using the latest 6 cup painless but deeply effective interferential based on NASA technology and movement enhancement strategies based on the very latest in brain plasticity etc. etc .
Should we encourage this?
I have used the quote many times, but from Pat Wall comes something like “in the end if everything is shown to be placebo, do not fear, but work out what it was in that placebo response that made the person better”