Perceptions: Positive Spin Adds to a Placebo’s Impact

By NICHOLAS BAKALAR
NYT

Can taking a placebo be effective even if the patient knows it is a placebo? A new report suggests the answer is yes.

In a study published online last week in the online journal PLoS One, researchers explained to 80 volunteers with irritable bowel syndrome that half of them would receive routine treatment and the other half would receive a placebo. They explained to all that this was an inert substance, like a sugar pill, that had been found to “produce significant improvement in I.B.S. symptoms through mind-body self-healing processes.” The patients, all treated with the same attention, warmth and empathy by the researchers, were then randomly assigned to get the pill or not.

At the end of three weeks, they tested all the patients with questionnaires assessing the level of their pain and other symptoms. The patients given the sugar pill — in a bottle clearly marked “placebo” — reported significantly better pain relief and greater reduction in the severity of other symptoms than those who got no pill. The authors speculate that the doctors’ communication of a positive outcome was one factor in the apparent effectiveness of the placebo.

“The magnitude of effect here is very large,” said the lead author, Dr. Ted J. Kaptchuk, a researcher at Beth Israel Deaconess Medical Center in Boston. The goal, he added, would be to develop a clinical strategy to use the placebo effect ethically, without lying to a patient.