31 May 2024

Placebo has been shown to be effective in mental disorders

It is possible to improve the well-being of patients suffering from mental disorders simply by believing that the medication taken will help. German doctors have found this out based on the results of an extensive meta-analysis of clinical trials in which some people were given "dummies" instead of real drugs.

For the review, the results of which were recently published in the journal JAMA Psychiatry, scientists selected 90 randomised placebo-controlled trials involving adult patients with mental disorders. Among the diagnoses included in the meta-analysis were depression, generalised anxiety disorder, panic disorder, attention deficit hyperactivity disorder, post-traumatic stress disorder, social phobia, mania, schizophrenia and obsessive-compulsive disorder.

In the placebo groups, where the number of subjects totalled almost 10 thousand people, the participants received preparations without the active active ingredient, although in appearance and taste they completely repeated the usual drugs.

Against the background of such "treatment" the condition of all patients improved significantly. The most noticeable progress was observed in those suffering from depressive and anxiety disorders. Relief of symptoms was noted in other types of mental disorders, but in the case of obsessive-compulsive disorder and schizophrenia, the positive effect was the least.

In a commentary for CNN, Tom Bschor, professor of psychiatry and one of the authors of the paper, attributed what happened to the placebo effect. This term is commonly used to refer to the improvement in a person's well-being due to hope and belief in the efficacy of a treatment.

"Placebos are administered in randomised double-blind trials and participants do not know if they will receive the active drug," Bschor explained.

Richard Keefe, professor emeritus of psychiatry and behavioural sciences at Duke University Medical Center in North Carolina, USA, also shared his opinion with the agency. According to the specialist, who was not involved in the study, talking to a psychiatrist and asking patients about their well-being could have played a positive role. He agreed that a belief in an improved condition can act in a healing way.

Another possible reason is the natural course of some disorders. Symptoms of mental disorders are episodic, appearing and disappearing over time. The condition of individual patients may partially or completely improve without any treatment, taking placebos or other interventions. Doctors call this spontaneous remission, Felipe Barreto Schuch, an associate professor of psychiatry and mental health at the Federal University of Santa Maria in Brazil, wrote in an email to CNN. He too was not involved in the meta-analysis.

However, it is unlikely to know which of the three factors is the main one because of limitations in research methods, Tom Bschor admitted. To establish the true impact of the placebo effect, it would additionally require a group taking no medication, or even their imitation, which is almost unrealistic in modern psychiatry, said the doctor.

However, the results of the meta-analysis are still important because they mean that participation of patients with psychiatric problems in placebo clinical trials is medically and ethically justified.

In addition, the researchers' findings confirm that there is nothing wrong with initially refusing a doctor-prescribed medication if the patient doubts the need to take it and wants to see if their condition will improve without it.

However, the authors emphasised that with more serious disorders such as schizophrenia and obsessive-compulsive disorder, improvements were minimal. This suggests that the need for medication is greater in such cases.

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