Placebo effect is defined as a reduction in symptoms resulting from one’s perception of the therapeutic intervention; this response may be biological and psychological. This paper reviewed quantitative and qualitative findings of how the patient-clinician relationship and the verbal suggestions given for pain relief may influence patients’ perception of a treatment and its outcome.The main findings were:

-Patient-clinician relationship and treatment rituals may influence patients’ perception of the treatment effects. A good relationship is characterized by an empathic, optimistic, competent clinician, and by a motivated, cooperative patient. -Patients may especially focus on the clinician’s like-ability, credibility or competency, which may strengthen expectations of efficacious treatments. -Verbal suggestions given for pain relief may also influence treatment outcome. Stronger suggestions induce greater placebo analgesia. -Expectations of pain relief contribute to placebo analgesia during treatment, and also lead to a reduction in anxiety, which may be a central component of the placebo effect. -Experience of pain reduction was correlated with decreased activity in pain-processing areas of the brain (fMRI).

Thus, by optimizing these experiential factors in ethically appropriate ways, this approach may assist clinicians and patients to derive optimum benefit from the placebo component found in every treatment. > From: Vase et al., Phil. Patients’ direct experiences as central elements of placebo analgesia. Trans. R. Soc. B 366 (2011) 1913-1921. All rights reserved to Royal Society Publishing.

Full Text Article:  http://rstb.royalsocietypublishing.org/content/366/1572/1913.full