[The role of placebo and nocebo mechanisms in depressive diseases and their treatment].

BACKGROUND

There is substantial evidence that placebo and nocebo effects occur during treatment with antidepressants. A better understanding of the underlying mechanisms of these effects is necessary to optimize the outcome of treatment and to make clinical studies more sensitive.

METHODS

Placebo and nocebo mechanisms were analyzed based on empirical studies and the results are summarized in a narrative review.

RESULTS

Clinical studies and also experimental mechanism-oriented studies underline the effects of placebo and nocebo mechanisms in the treatment with antidepressants.

CONCLUSION

The success of treatment in the use of antidepressants can be increased and the probability of side effects can be reduced by the effective use of placebo mechanisms and reduction of nocebo effects. The results emphasize the influence of clinician-patient interactions, the role of the treatment context and previous experiences with other treatments of the patient. Simultaneously, the results of this research field stimulate a new understanding of mental disorders, in particular depression and also provide points of reference for optimization of psychotherapeutic treatment.