Everyone knows that a placebo — a fake medication or sham procedure, typically used as a control in a medical trial — can nonetheless have a positive effect, relieving real symptoms like pain, bloating or a depressed mood. The placebo effect is a result of the patient’s expectation that the treatment will help.


But expectations can also do harm. When a patient anticipates a pill’s possible side effects, he can suffer them even if the pill is fake. This “nocebo” effect has been largely overlooked by researchers, clinicians and patients. In an article recently published in the journal Deutsche Ärzteblatt International, Ernil Hansen and colleague reviewed 31 studies, conducted by other researchers, that demonstrated the nocebo effect. We urge doctors and nurses to be more mindful of its dangers, particularly when informing patients about a treatment’s potential complications.

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