Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, USA.
School of Medicine, University of Maryland, Baltimore, MD, United States.
Contemp Clin Trials. 2022 May;116:106734. doi: 10.1016/j.cct.2022.106734. Epub 2022 Mar 17.
Sex differences exist in the prevalence, progression and treatment efficacy of a wide array of medical conditions. While the placebo and nocebo effects have become increasingly relevant in the clinical arena, little is known about the influence of biological sex on placebo and nocebo effects. This paper discusses the existing, relatively limited and sometimes conflicting evidence about how sex impacts the occurrence and magnitude of the placebo and nocebo effects, mainly focusing on pain studies. We present recent evidence that when compared to men, women suffering from chronic orofacial pain may derive greater benefit from the placebo effect for analgesia. Nonetheless, we broadly argue that the field is not currently positioned to draw definitive conclusions and propose several important factors that may explain the inconsistency in the literature and that should be taken into account in future research. These include the specific target symptom of the placebo or nocebo manipulation and whether or not the target is related to the medical condition, the placebo or nocebo induction method, the sex of the experimenter or physician, and so forth. Future research should intentionally include sex a biological variable to favor translation of placebo and nocebo mechanisms into clinical applications.
性别差异存在于广泛的医学病症的流行、进展和治疗效果中。虽然安慰剂和反安慰剂效应在临床领域变得越来越相关，但关于生物性别对安慰剂和反安慰剂效应的影响知之甚少。本文讨论了现有的、相对有限且有时相互矛盾的证据，这些证据表明性别如何影响安慰剂和反安慰剂效应的发生和程度，主要集中在疼痛研究上。我们提出了最近的证据，表明与男性相比，患有慢性口腔面部疼痛的女性可能从镇痛的安慰剂效应中获得更大的益处。尽管如此，我们广泛认为，该领域目前还无法得出明确的结论，并提出了几个可能解释文献中不一致性的重要因素，这些因素应该在未来的研究中考虑。这些因素包括安慰剂或反安慰剂操作的特定目标症状，以及目标是否与医学状况、安慰剂或反安慰剂诱导方法、实验者或医生的性别等相关。未来的研究应该有意将性别作为一个生物学变量来促进安慰剂和反安慰剂机制向临床应用的转化。
