The placebo response in functional bowel disorders: perspectives and putative mechanisms

Authors: enck, p.¹; klosterhalfen, s.²

Source: Neurogastroenterology and Motility, Volume 17, Number 3, June 2005 , pp. 325-331(7)

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Abstract:

The nature and determinants of the placebo response are widely unknown, as are the underlying psychological and biological mechanisms. High placebo response rates in functional bowel disorders (functional dyspepsia, irritable bowel syndrome) are similar to those in non-intestinal diseases (depression, pain, Parkinson's disease) and not too dissimilar to other organic gastrointestinal diseases (duodenal ulcer, inflammatory bowel diseases). Methodological reasons (regression to the mean, shift in signal detection through manipulation of expectations) and psycho-biological mechanisms (Pavlovian conditioning of biological processes) are proposed to explain a large component of the response variance in clinical trials. Psychobiological mechanisms of the placebo response in functional and organic diseases can also be identified in brain function studies (such as imaging).

Keywords: clinical trials; functional bowel disorders; placebo response

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2982.2005.00676.x

Affiliations: 1: Department of Internal Medicine VI/Psychosomatics, University Hospitals Tuebingen, Tuebingen 2: Institute for Medical Psychology, University Hospitals Duesseldorf, Duesseldorf, Germany

Publication date: 2005-06-01