Ciaramella A, Paroli M, Poli P
Pain Therapy Unit, Department of Oncology, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, Pisa 56127, Italy.
ISRN Neurosci. 2013 Feb 12;2013:574526. doi: 10.1155/2013/574526. eCollection 2013.
Introduction. The nocebo effect consists in delivering verbal suggestions of negative outcomes so that the subject expects clinical worsening. Several studies indicate that negative verbal suggestions may result in the amplification of pain. Amplification style is one of the most important dimensions in psychosomatic research. Methods. One group of pain therapy unit patients was evaluated at baseline and again after 6 months from the beginning of the pain treatment. Results. Only 43% of 86 chronic pain patients respond positively to the expectation of sham pain. This group shows at baseline higher pain intensity (t value: 2.72, P = 0.007) and lower cold pain threshold (t value: 2.18, P = 0.03) than the group of subjects with any response to sham pain stimulus. Somatoform dimensions influence positively the strength of nocebo response in those predisposed to it. Conclusion. Our study shows that the power of the nocebo phenomenon seems to be a dimension belonging to the investigation in psychosomatic. In contrast to what one might expect, the presence of the nocebo phenomenon affects positively pain relief and the outcome of pain treatment. In a clinical setting, and the meaning of nocebo response does not seem to be different from placebo response.
引言。反安慰剂效应在于给出负面结果的言语暗示，从而使受试者预期临床症状会恶化。多项研究表明，负面言语暗示可能会导致疼痛加剧。放大方式是身心研究中最重要的维度之一。方法。一组疼痛治疗单元的患者在基线时接受评估，并在疼痛治疗开始6个月后再次接受评估。结果。86名慢性疼痛患者中只有43%对假痛预期有积极反应。与对假痛刺激有任何反应的受试者组相比，该组在基线时疼痛强度更高（t值：2.72，P = 0.007），冷痛阈值更低（t值：2.18，P = 0.03）。躯体形式维度对易患反安慰剂反应者的反安慰剂反应强度有积极影响。结论。我们的研究表明，反安慰剂现象的影响力似乎是身心研究范畴内的一个维度。与人们可能预期的情况相反，反安慰剂现象的存在对疼痛缓解和疼痛治疗结果有积极影响。在临床环境中，反安慰剂反应的意义似乎与安慰剂反应并无不同。
