An emerging dimension in psychosomatic research: the nocebo phenomenon in the management of chronic pain.
An emerging dimension in psychosomatic research: the nocebo phenomenon in the management of chronic pain.
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DOI：
10.1155/2013/574526
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发表时间：
2013-01-01
期刊：
影响因子：
--
通讯作者：
Poli, P
中科院分区：
文献类型：
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作者：
Ciaramella, A;Paroli, M;Poli, P
介绍。反安慰剂效应包括口头暗示负面结果，使受试者预期临床恶化。一些研究表明，消极的言语暗示可能会导致痛苦的放大。放大类型是心身研究中最重要的维度之一。方法。一组疼痛治疗单元患者在基线和疼痛治疗开始6个月后再次进行评估。结果。86名慢性疼痛患者中只有43%对假性疼痛的预期反应积极。在基线时，实验组的疼痛强度（t值：2.72,P = 0.007）高于对照组，冷痛阈值（t值：2.18,P = 0.03）低于对照组。身体形态维度正向影响反安慰剂反应倾向者的反安慰剂反应强度。结论。我们的研究表明，反安慰剂现象的力量似乎是属于心身研究的一个维度。与人们可能期望的相反，反安慰剂现象的存在对疼痛缓解和疼痛治疗的结果有积极的影响。在临床环境中，反安慰剂反应的意义似乎与安慰剂反应没有什么不同。
Introduction. The nocebo effect consists in delivering verbal suggestions of negative outcomes so that the subject expects clinical worsening. Several studies indicate that negative verbal suggestions may result in the amplification of pain. Amplification style is one of the most important dimensions in psychosomatic research. Methods. One group of pain therapy unit patients was evaluated at baseline and again after 6 months from the beginning of the pain treatment. Results. Only 43% of 86 chronic pain patients respond positively to the expectation of sham pain. This group shows at baseline higher pain intensity (t value: 2.72, P = 0.007) and lower cold pain threshold (t value: 2.18, P = 0.03) than the group of subjects with any response to sham pain stimulus. Somatoform dimensions influence positively the strength of nocebo response in those predisposed to it. Conclusion. Our study shows that the power of the nocebo phenomenon seems to be a dimension belonging to the investigation in psychosomatic. In contrast to what one might expect, the presence of the nocebo phenomenon affects positively pain relief and the outcome of pain treatment. In a clinical setting, and the meaning of nocebo response does not seem to be different from placebo response.