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Sieg M, Clemens KS, Colloca L, Geers AL, Vase L. Nocebo belief and attitudes towards side effect disclosure: A general population-based online survey in Europe and North America. Eur J Pain 2024. [PMID: 38956765 DOI: 10.1002/ejp.2305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/28/2024] [Accepted: 06/07/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND With evidence for large nocebo effects in pain, guidelines for nocebo-minimizing strategies regarding side effect disclosure are emerging. While the ethical implications and effectiveness of such strategies have been the subject of investigations, the perspective of healthcare users are missing despite the stakes for patient autonomy. METHODS In an online survey, 2766 adults (≥18 years) from a general population sample in Europe and North America responded to questions related to nocebo familiarity, nocebo beliefs and attitudes towards side effect disclosure. RESULTS Only 474 (17%) were familiar with nocebo terminology, while 1379 (50%) were familiar with the concept of nocebo side effects. Belief in nocebo side effects was not well-established; 738 (31%) agreed that side effect information could increase side effect occurrence. Nocebo belief was associated with more negative attitudes towards side effect disclosure and 1962 (73%) indicated that positive framing was an acceptable way of disclosing side effect information. In general, the majority of participants (65-76%) held positive attitudes towards the disclosure of all potential side effects and 2309 (84%) favoured patient autonomy over nonmaleficence. Although the general patterns were similar in the European and North American sample, the latter showed stronger nocebo belief and stronger positive attitudes towards side effect disclosure. CONCLUSIONS The study found a consistent, moderate association between nocebo belief and attitudes towards nondisclosure, alongside positive attitudes towards the use of framing. Together with the discovered discrepancy between nocebo familiarity and nocebo belief, these findings have implications for the implementation of nocebo education and risk framing strategies. SIGNIFICANCE STATEMENT This is the first large-scale, general population-based study to contribute to the scientific discussion about nocebo side effects from the perspective of healthcare users. The findings have implications for the discussion on how to handle the medical and ethical problem of nocebo side effects in clinical practice.
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Affiliation(s)
- Mette Sieg
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Kelly S Clemens
- Department of Psychology, Illinois State University, Normal, Illinois, USA
| | - Luana Colloca
- Department of Pain Translational Symptoms Science, University of Maryland, Baltimore, Baltimore, Maryland, USA
| | - Andrew L Geers
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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2
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Clemens KS, Vang M, Colloca L, Sieg M, Vase L, Ruble A, Geers AL. The desire for side-effect information in pain treatment: an experimental analysis of contextual and individual difference factors. Pain 2024; 165:383-391. [PMID: 37975871 DOI: 10.1097/j.pain.0000000000003025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/19/2023] [Indexed: 11/19/2023]
Abstract
ABSTRACT Informing patients about potential side effects of pain treatment is a requirement that protects patients and aids decision making, but it increases the likelihood of unwanted nocebo side effects. If patients do not desire all side-effect information, it may be possible to ethically reduce nocebo effects through authorized concealment of side effects, whereby patients and clinicians engage in shared decision-making to regulate the disclosure of side-effect information. Currently, there is no experimental data clarifying the factors that causally influence desire for side-effect information in pain treatment. In 2 cross-sectional, between-subjects scenario experiments (experiment 1 N = 498, experiment 2 N = 501), 18 to 79-year-old community adults learned about a lower back pain treatment, and potential side-effect severity, frequency, and duration were manipulated. Individual differences in information avoidance were also recorded. In both experiments, participants reported high desire for side-effect information, but the desire was reduced when side effects were described as less severe, less frequent, and participants scored high in information avoidance. Results were not moderated by participants' level of contact with the health care system, chronic health condition, or clinical pain history. Additional analyses indicated that low side-effect severity and frequency lessen desire for side-effect information because these variables reduce belief that side-effect information will be needed in the future and lower feelings of anticipated regret. The experiments identify situational and individual-difference factors that decrease the desire for side-effect information and provide evidence on when and for whom it may be useful for physicians to engage in shared medical decision-making with the goal of reducing nocebo side effects.
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Affiliation(s)
- Kelly S Clemens
- Department of Psychology, Illinois State University, Normal, IL, United States
| | - Michael Vang
- Department of Psychology, University of Toledo, Toledo, OH, United States
| | - Luana Colloca
- Pain and Translational Symptom Science Department, and Placebo Beyond Opinions Center, University of Maryland School of Nursing, Baltimore, MD, United States
| | - Mette Sieg
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Abigail Ruble
- Department of Counselor Education, Capital University, Bexley, OH, United States
| | - Andrew L Geers
- Department of Psychology, University of Toledo, Toledo, OH, United States
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3
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Nasiri-Dehsorkhi H, Vaziri S, Esmaillzadeh A, Adibi P. Psychological distress, perceived stress and nocebo effect (multifood adverse reaction) in irritable bowel syndrome patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:257. [PMID: 37727431 PMCID: PMC10506782 DOI: 10.4103/jehp.jehp_221_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/03/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Psychological distress and perceived stress may complicate the clinical presentation, course, and treatment of patients with functional gastrointestinal disorders. The correlation between psychological distress, perceived stress, and the nocebo effect (multifood adverse reaction) in patients with irritable bowel syndrome (IBS) was the main aim of the present study. MATERIALS AND METHODS In this cross-sectional correlation study, data on 4,763 Iranian adults, 748 of whom by purposive sampling were patients with IBS (65.1% female), working in 50 different health centers affiliated to the Isfahan University of Medical Sciences across Isfahan province were examined. For assessing dietary intake, a 106-item self-administered Dish-based Semi-Quantitative Food Frequency Questionnaire that was specifically designed and validated for Iranian adults was used. General Heath Questionnaire 12 and Stressful Life event Questionnaire were used to assess psychological distress and perceived stress. By using a modified Persian version of the Rome III questionnaire, IBS was assessed. Based on researcher-made definition of nocebo effect (multiitem food intolerance), 164 people had the nocebo phenomenon in IBS group. RESULTS Age, sex, education, marital status, antidepressant use, and specifically chronic underlying disease (odds ratio [OR]: 3.54, 95% confidence interval [CI]: 1.73-7.23) of general characteristics had a significant correlation (P <.05) with presenting nocebo responses in IBS patients. Psychological distress (OR: 1.415; 95% CI: 0.992-2.020; P = 0.056) had a significant correlation with nocebo effect and did not find significant correlation with perceived stress (OR: 0.999; 95% CI: 0.990-1.008; P = 0.865). Data were analyzed by Chi-square test, analysis of variance, and OR. CONCLUSION The present study showed that psychological distress with chronic underlying disease and antidepressant use are important elements in presenting multifood adverse reactions that we named here as the nocebo effect in IBS patients. Reducing psychological distress and managing chronic underlying diseases appear to be an effective factor in reducing the nocebo phenomenon in IBS patients. For managing the nocebo responses in IBS patients, these findings may help clinicians to improve their interventions. Further studies are required to confirm these findings.
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Affiliation(s)
- Hamid Nasiri-Dehsorkhi
- Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Vaziri
- Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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4
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Watanabe T, Sieg M, Lunde SJ, Persson M, Taneja P, Baad-Hansen L, Pigg M, Vase L. Nocebo response in dentistry: A systematic review and meta-analysis of adverse events in analgesic trials of third molar removal. J Oral Rehabil 2023; 50:332-342. [PMID: 36648379 DOI: 10.1111/joor.13414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 11/09/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND The nocebo response refers to the phenomenon where non-specific factors, including negative verbal suggestion and treatment expectations, cause adverse events (AE) following a placebo treatment. Non-specific factors are also likely to influence AE occurrence following administration of active pharmacological treatments. OBJECTIVE This meta-analysis aimed to estimate the nocebo response in dentistry by assessing the AEs prevalence in placebo- and active arms of randomised controlled trials (RCTs) assessing analgesic treatment following third molar (M3) surgery. METHODS A systematic search was performed in PubMed, Embase, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials. Eligible studies had to report the number of patients experiencing at least one drug-related AE (patients with AE ≥ 1) separately for the active and placebo arms. The proportion of patients with AE ≥ 1 and drug-related dropouts were pooled, and risk differences (RDs) between patients in the placebo- and active arm were calculated. RESULTS In 50 independent RCTs of 47 identified articles, the pooled rates of patients with AE ≥ 1 were 22.8% in the placebo arm and 20.6% in the active arm. The pooled rates of drug-related dropout were 0.24% in the placebo arm and 0.08% in the active arm. There were no significant RDs in patients with AE ≥ 1 and drug-related dropouts. CONCLUSION These results show that patients in the placebo arm reported AEs to the same extent as patients receiving active treatment, suggesting that most AEs in analgesic medication following M3 surgery may be attributed to the nocebo phenomenon.
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Affiliation(s)
- Takeshi Watanabe
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.,Department of Preventive Medicine, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mette Sieg
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Sigrid Juhl Lunde
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Mads Persson
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Pankaj Taneja
- Section of Oral and Maxillofacial Surgery and Oral Pathology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center of Orofacial Neurosciences, Aarhus, Denmark.,Scandinavian Center of Orofacial Neurosciences, Malmö, Sweden
| | - Lene Baad-Hansen
- Scandinavian Center of Orofacial Neurosciences, Aarhus, Denmark.,Scandinavian Center of Orofacial Neurosciences, Malmö, Sweden.,Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Maria Pigg
- Scandinavian Center of Orofacial Neurosciences, Aarhus, Denmark.,Scandinavian Center of Orofacial Neurosciences, Malmö, Sweden.,Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Lene Vase
- Department of Psychology and Behavioural Sciences, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
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Schäfer I, Oltrogge JH, Nestoriuc Y, Warren CV, Brassen S, Blattner M, Lühmann D, Tinnermann A, Scherer M, Büchel C. Expectations and Prior Experiences Associated With Adverse Effects of COVID-19 Vaccination. JAMA Netw Open 2023; 6:e234732. [PMID: 36972051 PMCID: PMC10043751 DOI: 10.1001/jamanetworkopen.2023.4732] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Importance Uptake of vaccination against COVID-19 is strongly affected by concerns about adverse effects. Research on nocebo effects suggests that these concerns can amplify symptom burden. Objective To investigate whether positive and negative expectations prior to COVID-19 vaccination are associated with systemic adverse effects. Design, Setting, and Participants This prospective cohort study analyzed the association of expected benefits and risks of vaccination, adverse effects at first vaccination, and observed adverse effects in close contacts with severity of systemic adverse effects among adults receiving a second dose of messenger RNA (mRNA)-based vaccines between August 16 and 28, 2021. A total of 7771 individuals receiving the second dose at a state vaccination center in Hamburg, Germany, were invited to participate; of these, 5370 did not respond, 535 provided incomplete information, and 188 were excluded retrospectively. The mobile application m-Path was used for data collection. Main Outcomes and Measures Primary outcome was a composite severity index of systemic adverse effects in 12 symptom areas measured once daily with an electronic symptom diary over 7 consecutive days. Data were analyzed by mixed-effects multivariable ordered logistic regression adjusted for prevaccine symptom levels and observation times. Results A total of 10 447 observations from 1678 individuals receiving vaccinations (BNT162b2 [Pfizer BioNTech] in 1297 [77.3%] and mRNA-1273 [Moderna] in 381 [22.7%]) were collected. The participants' median age was 34 (IQR, 27-44) years, and 862 (51.4%) were women. The risk for more severe adverse effects was higher for persons expecting a lower benefit of vaccination (odds ratio [OR] for higher expectations, 0.72 [95% CI, 0.63-0.83]; P < .001), expecting higher adverse effects of vaccination (OR, 1.39 [95% CI, 1.23-1.58]; P < .001), having experienced higher symptom burden at the first vaccination (OR, 1.60 [95% CI, 1.42-1.82]; P < .001), scoring higher on the Somatosensory Amplification Scale (OR, 1.21 [95% CI, 1.06-1.38]; P = .004), and if the vaccine mRNA-1273 was given rather than BNT162b2 (OR, 2.45 [95% CI, 2.01-2.99]; P < .001). No associations were seen for observed experiences. Conclusions and Relevance In this cohort study, several nocebo effects occurred in the first week after COVID-19 vaccination. The severity of systemic adverse effects was associated not only with vaccine-specific reactogenicity but also more negative prior experiences with adverse effects from the first COVID-19 vaccination, more negative expectations regarding vaccination, and tendency to catastrophize instead of normalize benign bodily sensations. Clinician-patient interactions and public vaccine campaigns may both benefit from these insights by optimizing and contextualizing information provided about COVID-19 vaccines.
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Affiliation(s)
- Ingmar Schäfer
- Institute and Outpatients Clinic of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Hendrik Oltrogge
- Institute and Outpatients Clinic of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yvonne Nestoriuc
- Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claire V Warren
- Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Brassen
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Blattner
- Institute and Outpatients Clinic of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Lühmann
- Institute and Outpatients Clinic of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexandra Tinnermann
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Institute and Outpatients Clinic of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Büchel
- Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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6
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de Bruijn CMA, Hamming GAC, Knibbe CAJ, Tromp E, Benninga MA, Vlieger AM. Teenagers' and parental individual needs for side effects information and the influence of nocebo effect education. PATIENT EDUCATION AND COUNSELING 2023; 108:107587. [PMID: 36516654 DOI: 10.1016/j.pec.2022.107587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES When developing a policy on how information about medication and its side effects (SE) should be provided in pediatrics, it is crucial to know individual needs. This paper investigates teenagers' and parental attitudes on information on SE, before and after education on the nocebo effect (NE). METHODS This multicenter survey study included 226 teenagers (12-18 years) and 525 parents of patients (0-18 years). Questions assessed demographics, clinical characteristics and attitudes towards the amount of SE information before and after the explanation of NE. RESULTS Before NE education, 679 (93 %) participants preferred to receive SE information: 337 (45 %) about all possible SE and 360 (48 %) desired specific information (i.e., severe, common, visible, or long-term SE). After NE explanation, significantly more participants (58 %) wished to receive information about all possible SE (p < .001). When explaining SE, teenagers preferred positive framing more than parents (64 % vs. 54 %, p = .043). CONCLUSIONS Most teenagers and parents wish to receive extensive SE information, even after explaining the NE, but variances in individual needs exist. PRACTICE IMPLICATIONS This study emphasizes the importance of tailor-made communication strategies for providing information on medications to parents and their children.
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Affiliation(s)
- Clara M A de Bruijn
- Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, Amsterdam, the Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands.
| | | | | | - Ellen Tromp
- Department of Statistics, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Marc A Benninga
- Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, Amsterdam, the Netherlands
| | - Arine M Vlieger
- Department of Pediatrics, St. Antonius Hospital, Nieuwegein, the Netherlands
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7
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Gerke L, Meyrose AK, Nestoriuc Y. Informed consent for psychotherapy: Ethical illusion or clinical reality? A survey about psychotherapists' attitudes and practices in Germany. Clin Psychol Psychother 2023; 30:166-178. [PMID: 36210744 DOI: 10.1002/cpp.2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to assess clinicians' attitudes and their current clinical practices regarding informed consent for psychotherapy. METHOD A convenience sample of N = 530 clinicians in Germany (n = 418 licensed psychotherapists and n = 112 postgraduate psychotherapy trainees) took part in an online survey. RESULTS Most clinicians (84%) reported obtaining informed consent for psychotherapy in their daily routine. However, many psychotherapists felt unsure about satisfactorily fulfilling the legal (63%) and ethical obligations (52%). The two most frequently reported components of information disclosure related to explaining the terms and conditions of psychotherapy (96%) and the psychotherapeutic approach (91%). Providing information about mechanisms of psychotherapy (33%) and the role of expectations (30%) were least practiced. One in five psychotherapists reported not informing clients about potential risks and side effects. A considerable proportion reported concern about inducing anxiety in patients by disclosing information about risks and side effects (52%). CONCLUSIONS Although obtaining informed consent for psychotherapy seems to be the rule rather than the exception in clinical practice, the quality of its implementation in terms of legal, ethical and clinical demands remains questionable. Training psychotherapists in providing comprehensive informed consent enables informed decision-making and might have a positive influence on treatment expectations and outcomes.
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Affiliation(s)
- Leonie Gerke
- Department of Clinical Psychology, Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Clinical Psychology, Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Hamburg, Germany.,Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yvonne Nestoriuc
- Department of Clinical Psychology, Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Hamburg, Germany.,Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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8
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Meeuwis SH, Skvortsova A, van Laarhoven AIM, Holle H, Evers AWM. Can contagious itch be affected by positive and negative suggestions? Exp Dermatol 2022; 31:1853-1862. [PMID: 36048562 PMCID: PMC10087404 DOI: 10.1111/exd.14663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/20/2022] [Accepted: 08/10/2022] [Indexed: 12/14/2022]
Abstract
Contagious itch can be evoked by observing people scratching. Verbal suggestions about to-be-received itch can influence itch intensity, as shown by placebo research, but it is unknown whether this extends to contagious itch. The current study aimed to replicate prior findings that listening to scratching and rubbing sounds elicits contagious itch, and to investigate whether suggestions can modulate this process. Healthy participants (n = 140) received positive or negative suggestions about itch in response to the sounds (aimed to decrease or increase expected itch, respectively), or no specific suggestions as a control. Participants listened to a number of audio fragments with scratching and rubbing sounds. The amount of expected itch as well as itch sensation after each audio fragment were measured by self-report. Suggestions had no effect on the expected itch. Both rubbing and scratching sounds significantly elicited itch in all groups. Scratching sounds induced more itch than rubbing sounds exclusively in the control group. These findings indicate that short suggestions might be not effective enough to modify the expectations of people regarding contagious itch. Furthermore, suggestions modulate contagious itch to some degree, but not in the hypothesized direction. Potential similarities and differences in the neurobiological mechanisms of contagious itch and nocebo effects are discussed.
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Affiliation(s)
- Stefanie H Meeuwis
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, the Netherlands.,Pain Research Group, Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Aleksandrina Skvortsova
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, the Netherlands.,Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Antoinette I M van Laarhoven
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, the Netherlands
| | - Henning Holle
- Department of Psychology, University of Hull, Hull, UK
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, the Netherlands.,Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, the Netherlands.,Medical Delta Healthy Society, Leiden University, Technical University Delft & Erasmus University Rotterdam, Rotterdam, the Netherlands
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9
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Factors Moderating the Link between Personal Recounts of COVID-19 Vaccine Side Effects Viewed on Social Media and Viewer Postvaccination Experience. Vaccines (Basel) 2022; 10:vaccines10101611. [PMID: 36298476 PMCID: PMC9610806 DOI: 10.3390/vaccines10101611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
While social media exposure is known to influence vaccine hesitancy, its impact on postvaccination experience remains relatively unknown. This retrospective cross-sectional study explored whether various psychosocial and individual factors moderate the association between social media exposure to personal recounts of COVID-19 vaccine side effects and the viewer’s subsequent postvaccination side effect experience. Adults residing in Australia, who were fully vaccinated with two COVID-19 vaccine doses (n = 280) completed an online survey. The more severe the personal recounts of post-COVID-19 vaccination side effects participants were exposed to on social media, the more severe their own postvaccination side effects were following both their first (β = 0.261, p < 0.001) and second dose (β = 0.299, p < 0.001). This association was stronger among those with greater vaccine side effect worry, elevated negative emotional states such as anxiety and stress, and a stronger proclivity for using social media over mainstream media for COVID-19 vaccine side effect information. As such, not only does social influence appear to exacerbate or trigger postvaccination side effects, but a range of psychosocial and situational factors moderate this association. Health organisations and government bodies could minimise the negative effects of social media exposure in future health outbreaks by countering treatment misperceptions on social media platforms as they arise.
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10
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Information needs and sources of information among people with depression and anxiety: a scoping review. BMC Psychiatry 2022; 22:502. [PMID: 35896995 PMCID: PMC9326147 DOI: 10.1186/s12888-022-04146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Previous studies have identified substantial unmet information needs in people with depression and anxiety. Sufficient information about the disorder, treatment, available services, and strategies for self-management is essential as it may influence quality of care and patients' quality of life. This scoping review aimed to provide a broad overview of information needs of people with depression and anxiety as well as the sources that they use to seek this information. METHODS We included all primary research published in English that investigated information needs or information sources in people with depression or anxiety, with no restrictions imposed on the study design, location, setting, or participant characteristics. Six electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, LISTA, Web of Science) and the grey literature (Google and Google Scholar) were searched for relevant studies published up to November 2021. Two reviewers independently screened articles and extracted data. Narrative synthesis was performed to identify key themes of information needs and information sources. Factors associated with information needs/sources such as demographic variables and symptom severity were also identified. RESULTS Fifty-six studies (comprising 8320 participants) were included. Information needs were categorised into seven themes, including general facts, treatment, lived experience, healthcare services, coping, financial/legal, and other information. The most frequently reported needs in both people with depression and anxiety were general facts and treatment information. Subclinical samples who self-reported depressive/anxious symptoms appeared less interested in treatment information than patients with clinical diagnoses. Information sources were summarised into five categories: health professionals, written materials, media, interpersonal interactions, and organisational resources. Health professionals and media (including the internet) were the most frequently adopted and preferred sources. Although few studies have examined factors associated with information needs and information sources, there is preliminary evidence that symptom severity and disease subtypes are related to information needs/sources, whereas findings on demographic factors were mixed. CONCLUSIONS Information needs appear to be high in people with depression and anxiety. Future research should examine differences between subgroups and associated factors such as the treatment course. Personalised information provision strategies are also needed to customise information according to individual needs and patient profiles. TRIAL REGISTRATION The protocol of this scoping review was registered on Open Science Framework (OSF; link: https://doi.org/10.17605/OSF.IO/DF2M6 ).
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11
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Digital tools for the assessment of pharmacological treatment for depressive disorder: State of the art. Eur Neuropsychopharmacol 2022; 60:100-116. [PMID: 35671641 DOI: 10.1016/j.euroneuro.2022.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 12/23/2022]
Abstract
Depression is an invalidating disorder, marked by phenotypic heterogeneity. Clinical assessments for treatment adjustments and data-collection for pharmacological research often rely on subjective representations of functioning. Better phenotyping through digital applications may add unseen information and facilitate disentangling the clinical characteristics and impact of depression and its pharmacological treatment in everyday life. Researchers, physicians, and patients benefit from well-understood digital phenotyping approaches to assess the treatment efficacy and side-effects. This review discusses the current possibilities and pitfalls of wearables and technology for the assessment of the pharmacological treatment of depression. Their applications in the whole spectrum of treatment for depression, including diagnosis, treatment of an episode, and monitoring of relapse risk and prevention are discussed. Multiple aspects are to be considered, including concerns that come with collecting sensitive data and health recordings. Also, privacy and trust are addressed. Available applications range from questionnaire-like apps to objective assessment of behavioural patterns and promises in handling suicidality. Nonetheless, interpretation and integration of this high-resolution information with other phenotyping levels, remains challenging. This review provides a state-of-the-art description of wearables and technology in digital phenotyping for monitoring pharmacological treatment in depression, focusing on the challenges and opportunities of its application in clinical trials and research.
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Abstract
ZusammenfassungErwartungseffekte bei Antidepressiva wurden in zahlreichen randomisierten Studien und Metaanalysen nachgewiesen. In den Placebogruppen zeigten sich sowohl relevante Verbesserungen der depressiven Erkrankungen (Ansprechraten: Placebo 40 % vs. Verum 50 %) als auch belastende Nebenwirkungen im Sinne von Noceboeffekten. Diese Befunde unterstreichen den Einfluss individueller Erwartungshaltungen auf die Wirksamkeit und Verträglichkeit von Antidepressiva und legen nahe, dass diese auch beim Absetzen relevant sind. Das Absetzen von Antidepressiva kann mit belastenden Beschwerden wie Schwindel, Schlaflosigkeit und Reizbarkeit verbunden sein. Diese sog. Absetzsymptome sind in der Mehrzahl der Fälle mild und klingen nach wenigen Tagen bis Wochen wieder ab. Sind Patient:innen allerdings nicht auf solche möglichen Beschwerden vorbereitet, kann deren Auftreten Ängste vor einem Rückfall oder einer Abhängigkeit auslösen. Insbesondere, wenn das Absetzen ohne ärztliche und psychologische Begleitung stattfindet, können Absetzsymptome leicht mit dem Wiederauftreten einer Depression verwechselt werden. In der aktuellen Versorgungspraxis finden sich zunehmend Berichte zu missglückten Absetzversuchen und entsprechend negativen Erwartungen an das Absetzen. Erwartungen lassen sich vornehmlich in der Interaktion mit Behandelnden und über die Patient:innen-Information verändern. Dieser Beitrag diskutiert therapeutische Strategien zum Umgang mit Absetzsymptomen mit dem Ziel, Erwartungen, angepasst an individuelle Vorerfahrungen, zu optimieren. Um realistische Erwartungen zu erarbeiten und den Absetzprozess durch eine therapeutische Begleitung positiv zu beeinflussen, können Strategien wie Psychoedukation, Framing, die Aufklärung über Placebo- und Noceboeffekte sowie die Erarbeitung von Coping-Strategien eingesetzt werden.
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Lin CH. Nocebo effects from COVID-19 and vaccination Hesitancy: The question of to be or not to be vaccinated. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_33_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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