Wampold Bruce E, Minami Takuya, Tierney Sandra Callen, Baskin Thomas W, Bhati Kuldhir S
Department of Counseling Psychology, University of Wisconsin-Madison, WI 53706, USA.
J Clin Psychol. 2005 Jul;61(7):835-54. doi: 10.1002/jclp.20129.
The logic of the randomized double-blind placebo control group design is presented, and problems with using the design in psychotherapy are discussed. Placebo effects are estimated by examining clinical trials in medicine and psychotherapy. In medicine, a recent meta-analysis of clinical trials with treatment, placebo, and no treatment arms was conducted (Hróbjartsson & Gøtzsche, 2001), and it was concluded that placebos have small or no effects. A re-analysis of those studies, presented here, shows that when disorders are amenable to placebos and the design is adequate to detect the effects, the placebo effect is robust and approaches the treatment effect. For psychological disorders, particularly depression, it has been shown that pill placebos are nearly as effective as active medications whereas psychotherapies are more effective than psychological placebos. However, it is shown that when properly designed, psychological placebos are as effective as accepted psychotherapies.
介绍了随机双盲安慰剂对照组设计的逻辑，并讨论了在心理治疗中使用该设计存在的问题。通过研究医学和心理治疗中的临床试验来评估安慰剂效应。在医学领域，最近对设有治疗组、安慰剂组和无治疗组的临床试验进行了一项荟萃分析（赫罗比亚特松和格茨彻，2001年），得出的结论是安慰剂的效果很小或没有效果。此处对这些研究进行的重新分析表明，当疾病对安慰剂有反应且设计足以检测出效果时，安慰剂效应很强，接近治疗效果。对于心理障碍，尤其是抑郁症，已表明药丸安慰剂的效果几乎与活性药物一样，而心理治疗比心理安慰剂更有效。然而，研究表明，经过合理设计后，心理安慰剂与公认的心理治疗方法效果相当。
