Grosso Francesca, Barbiani Diletta, Cavalera Cesare, Volpato Eleonora, Pagnini Francesco
Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Brain Behav Immun Health. 2024 May 22;38:100800. doi: 10.1016/j.bbih.2024.100800. eCollection 2024 Jul.
This meta-review aims to identify and categorize the risk factors that are associated with nocebo effects. The nocebo effect can exert a negative impact on treatment outcomes and have detrimental outcomes on health. Learning more about its potential predictors and risk factors is a crucial step to mitigating it.
Literature review studies about the risk factors for nocebo effects were searched through five databases (PubMed, Scopus, The Cochrane Library, PsycINFO, and Embase) and through grey literature. Methodological validity and risk of bias were assessed. We conducted a thematic analysis of the results of the forty-three included reviews.
We identified nine categories of risk factors: prior expectations and learning; socio-demographic characteristics; personality and individual differences; neurodegenerative conditions; inflammatory conditions; communication of information and patient-physician relationship; drug characteristics; setting; and self-awareness. We also highlighted the main biochemical and neurophysiological mechanisms underlying nocebo effects.
Nocebo effects arise from expectations of adverse symptoms, particularly when triggered by previous negative experiences. A trusting relationship with the treating physician and clear, tailored treatment instructions can act as protective factors against a nocebo effect. Clinical implications are discussed.
本荟萃综述旨在识别与反安慰剂效应相关的风险因素并进行分类。反安慰剂效应会对治疗结果产生负面影响，并对健康造成有害后果。更多地了解其潜在预测因素和风险因素是减轻该效应的关键一步。
通过五个数据库（PubMed、Scopus、Cochrane图书馆、PsycINFO和Embase）以及灰色文献搜索关于反安慰剂效应风险因素的文献综述研究。评估方法学有效性和偏倚风险。我们对纳入的43篇综述的结果进行了主题分析。
我们识别出九类风险因素：先前的期望与学习；社会人口统计学特征；人格与个体差异；神经退行性疾病；炎症性疾病；信息沟通与医患关系；药物特性；环境；以及自我意识。我们还强调了反安慰剂效应背后的主要生化和神经生理机制。
反安慰剂效应源于对不良症状的预期，尤其是由先前的负面经历引发时。与治疗医生建立信任关系以及清晰、量身定制的治疗指导可作为抵御反安慰剂效应的保护因素。讨论了其临床意义。
