Nocebo effects, patient–clinician communication, and therapeutic outcomes
Open accessAbstract
NOCEBO EFFECTS ARE ADVERSE EVENTS PRODUCED by negative expectations and represent the negative side of placebo effects.It is now recognized that nocebo effects exist and operate during routine treatments, negatively affecting clinical outcomes even when placebos are not administered.The nocebo effects and placebo effects are the direct result of the psychosocial context or therapeutic environment on a patient's mind, brain, and body.Both phenomena can be produced by multiple factors, such as verbal suggestions and past experience. 1In the case of nocebo effects, negative information and prior unsuccessful therapies may be particularly important in mediating undesirable outcomes to routine therapy.Therefore, consideration of nocebo effects in the context of patient-clinician communication and disclosure in routine practice may be valuable in both minimizing the nocebo component of a given therapy and improving outcomes.
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Negative expectations may play a role in producing side effects and adverse events during trials and treatment.
“Similarly, there is evidence suggesting that negative expectations can contribute to a variety of side effects and adverse events in clinical trials and medical care (Amanzio et al., 2009; Barsky et al., 2002; Colloca and Finniss, 2012; Petersen et al., 2014).”
From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Colloca and Finniss, 2012
Nocebo hyperalgesia has received less research attention than placebo analgesia.
“Relatively fewer studies have focused on nocebo hyperalgesia (Benedetti et al., 2003; Colloca and Benedetti, 2007; Colloca and Finniss, 2012; Geuter and Buchel, 2013; Kong et al., 2008; Schmid et al., 2013; Scott et al., 2008).”
From Distinct neural representations of placebo and nocebo effects (2015) · cites this paper as Colloca and Finniss, 2012
The duration of prior events marked with exposure to pain is relevant for the development and perpetuation of nocebo-induced algesia.
“The duration of prior events marked with exposure to pain is also relevant for the development and perpetuation of nocebo-induced algesia.24,26,33–35”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [26]
Colloca and Benedetti showed that participants who were observing an analgesic effect in another person when a light flashed displayed analgesia when they were exposed to the same light paired with high level of pain.
“Colloca and Benedetti26 showed that the participants who were observing an analgesic effect in another person when a light flashed, displayed analgesia when they were exposed to the same light paired with high level of pain.”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [26]
Social learning produced placebo effects of the same magnitude as classical conditioning.
“Social learning produced placebo effects of the same magnitude as classical conditioning.26”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [26]
The placebo analgesia generated in the observer positively correlated with the grade of empathy of the observer.
“In particular, the placebo analgesia generated in the observer positively correlated with the grade of empathy of the observer.”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [26]
Social observation (vicarious learning) played an important role in the development of placebo effects.
“The social observation (vicarious learning) played an important role in the development of placebo effects.”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [26]
In laboratory settings, recent studies provide evidence that personality and psychological factors are critically associated with aversive responses to pain and proneness to nocebo effects.
“In laboratory settings, recent studies have begun to provide evidence that personality and psychological factors are critically associated with aversive responses to pain and proneness to nocebo effects.26”
From Nocebo and pain: an overview of the psychoneurobiological mechanisms (2017) · cites this paper as [26]
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Diagnosis and management of resistant hypertension: state of the art
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Can attention control conditions have detrimental effects on behavioral medicine randomized trials?
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Self-citationAn Introduction to Biosimilars for the Treatment of Retinal Diseases: A Narrative Review
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- Authors
- Colloca, L., & Finniss, D.
- Affiliations
- National Institutes of Health (US)
- The University of Sydney (AU)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2012-02-08
- Volume
- 307
- Issue
- 6
- Pages
- 567-8
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC6909539
- OpenAlex
- W2020713670
- Cited by
- 326
- References
- 8
- Citations by year
- 2026: 14 · 2025: 14 · 2024: 13 · 2023: 13 · 2022: 26 · 2021: 17 · 2020: 23 · 2019: 32 · 2018: 27 · 2017: 27 · 2016: 26 · 2015: 30 · 2014: 25 · 2013: 22 · 2012: 17
- FWCI
- 15.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health (Z99 MH999999)
- National Center for Complementary and Alternative Medicine
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- nocebo effect, placebo effect, patient-clinician communication, negative expectations, verbal suggestion, adverse drug reactions, treatment outcomes
- MeSH terms
- Clinical Trials as Topic, Communication, Humans, Informed Consent, Physician-Patient Relations, Psychophysiology, Placebo Effect, Treatment Outcome, Disclosure
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