Study Reveals Placebos' Impact on Mental Health Disorders
A recent study highlights the positive effects of placebo treatment on various mental disorders, showing significant symptom improvements across nine different conditions. Dive into the findings of this large-scale research that sheds light on the potential benefits of placebos in managing mental health concerns.
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When you’re dealing with mental health symptoms, just believing that you can get help might be crucial.
A new review of 90 randomized controlled trials, known as a meta-analysis, found that symptoms of nine mental health disorders showed significant improvement when participants were given a placebo. The study included 9,985 adults, mostly in their 30s and 40s.
The disorders examined in the review, which was published in the journal JAMA Psychiatry on Wednesday, included major depressive disorder, mania, schizophrenia, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), panic disorder, post-traumatic stress disorder (PTSD), and social phobia.
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Experts discuss whether exercise or medication is more effective for treating depression. According to Dr. Tom Bschor, a professor of psychiatry at the University Hospital Dresden in Germany, placebo tablets used in studies look and taste the same as actual medications but do not contain the active ingredient. Instead, placebos have inactive substances known as excipients.
In the past, there has been a dilemma regarding the use of placebo treatment for individuals with mental health disorders. Dr. Jonathan Alpert, from the Albert Einstein College of Medicine, mentioned that researchers have hesitated to use placebos as it means not providing proper treatment for the condition, which could potentially worsen symptoms for the participants. However, there are plans in place to address this concern.
Dr. Alpert noted that in a recent analysis, participants who received placebo treatment actually showed improvement. This suggests that using placebo controls in studies can be beneficial, according to Dr. Alpert, who was not part of the study.
"It would be difficult to interpret the data without this information," he mentioned when discussing the impact of active medication. He also highlighted that this study on placebo effects in psychiatry is the most thorough one to date.
Bschor emphasized the significance of these findings for patient care.
"According to Bschor, the positive impact seen across various diagnoses supports the medical and ethical rationale for patients to join clinical trials that include placebo arms in the future. He also mentioned that clinicians have the ability to recommend their patients to take part in these trials, taking into account the possibility of being placed in the placebo group."
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The study also indicates that it may be alright to delay taking prescription medications for certain disorders if patients are hesitant or anxious about starting medication. This approach allows patients to observe if their condition gets better without medication, according to Bschor.
However, for disorders like OCD or schizophrenia, where placebos did not show significant improvement, medication may be more crucial in managing the symptoms.
Improvement in absence of medication
That mental health symptoms improved with placebo treatment may be due to a few potential influences, experts said.
Bschor explained that the first aspect is the placebo effect, which involves creating hope and belief in the effectiveness of a treatment. In randomized, double-blind studies, participants are unaware if they are receiving an active drug.
Dr. Richard Keefe highlighted the importance of mental health professionals asking about a patient's condition, stating that it is one of the most powerful effects in the field of medicine. He is a professor emeritus at Duke University Medical Center in North Carolina, specializing in psychiatry, behavioral sciences, and psychology.
Belief that things can get better can be healing, added Keefe, who wasn’t involved in the study.
The findings may also reflect the natural courses of some disorders, experts said.
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According to Dr. Felipe Barreto Schuch, an adjunct professor of psychiatry and mental health at Brazil’s Federal University of Santa Maria, mental disorders can come and go in episodes. Some people may see improvement in their symptoms without any treatment, placebo, or intervention. This natural improvement is known as spontaneous remission. It's important to note that Schuch was not part of the study mentioned.
The likelihood of spontaneous remission is particularly high for depression and anxiety. These two disorders have the highest rates of spontaneous remission and were found to benefit the most from placebo treatment in a recent study, according to experts.
One major limitation highlighted by Bschor is the inability to distinguish between the three main influences mentioned earlier. He mentioned that isolating the true extent of the placebo effect would necessitate studies with a group that receives no medication at all, not even a placebo, in addition to the placebo arm. However, such studies are rare in the field of psychiatry.
The effectiveness of placebos varies for different disorders. Symptoms of disorders like depression, which include sadness, are more responsive to attention and reassurance compared to symptoms of schizophrenia like hallucinations, according to Keefe.
Another factor that influences the effectiveness of placebos for schizophrenia and OCD is the biological contributions to these disorders, as pointed out by Alpert.
Genetics play a significant role in the risk of developing depression or anxiety, accounting for 30% to 40%, according to experts. However, life events also have a crucial impact on the likelihood of developing major depressive disorder or generalized anxiety disorder. On the other hand, disorders such as schizophrenia or OCD are more influenced by genetics, with 70% to 80% of the risk being genetic factors.
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If you're dealing with one of these disorders and unsure about the best treatment, remember that medications continue to be more effective than placebos, according to Alpert. The research indicates that being in a supportive environment where people are concerned about you and providing information about your condition is a positive step. Additionally, medication can offer even more benefits.
If you are trying to see if your symptoms improve without medication, it is important to continue regular doctor visits and therapy. According to Bschor, if you do not see any improvement after a few weeks, it may be time to reconsider the need for medication.
Editor's P/S:
The article highlights the significant impact of placebos on mental health symptoms, offering hope for those hesitant about medication. The positive results across various diagnoses support the inclusion of placebo arms in clinical trials, allowing patients to make informed decisions. It also emphasizes the potential for spontaneous remission, particularly in disorders like depression and anxiety, suggesting that belief and support can play a therapeutic role. However, the article acknowledges the limitations of placebos in treating disorders with strong biological contributions, such as schizophrenia and OCD. Ultimately, the findings underscore the importance of seeking professional help and considering a combination of medication and supportive care for optimal treatment outcomes.
