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Nocebo and the potential harm of 'high risk' labelling: a scoping review.
J Adv Nurs 2015; 71(7):1518-29JA

Abstract

AIMS

A discussion of the existence, prevalence and characteristics of the nocebo effect in health care.

BACKGROUND

There is increasing but inconsistent evidence for nocebo effects (the opposite of placebo). Causal mechanisms are believed to be similar to placebo (negative effects result from suggestions of negative clinical outcomes). Risk screening in health care may produce this unintended effect through labelling some patients as high risk. Given health care's almost universal coverage this potentially affects many people.

DESIGN

Discussion paper following a scoping review of the existence and frequency of nocebo.

DATA SOURCES

Literature databases (PsycINFO, MEDLINE, CCTR, CINAHL and EMBASE) searched from inception dates to 2013.

IMPLICATIONS FOR NURSING

Significant empirical evidence indicates that negative beliefs may impact on health outcomes (incidence estimates range from 3-27%). The nocebo effect, rooted in the complex interplay between physiological functioning and social factors, appears significantly more common among women and where prior negative knowledge or expectations exist. Pre-existing psychological characteristics (anxiety, neuroses, panic disorder or pessimism) exacerbate it.

CONCLUSION

While the placebo effect is well documented, there has been no systematic attempt to synthesize primary empirical research on the role of nocebo. It is possible that nocebo outcomes may be preventable through careful consideration of information provision and the prior identification of potentially high risk individuals. This paper summarizes the scale and importance of the nocebo effect, its distribution according to a range of social and clinical variables and its known relation to psychological precursors. It identifies important gaps in the research literature.

Authors+Show Affiliations

Mother and Infant Research Unit, University of Dundee, UK.NMAHP Research Unit, University of Stirling, UK.King's College Hospital, London, UK.NMAHP Research Unit, University of Stirling, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25702534

Citation

Symon, Andrew, et al. "Nocebo and the Potential Harm of 'high Risk' Labelling: a Scoping Review." Journal of Advanced Nursing, vol. 71, no. 7, 2015, pp. 1518-29.
Symon A, Williams B, Adelasoye QA, et al. Nocebo and the potential harm of 'high risk' labelling: a scoping review. J Adv Nurs. 2015;71(7):1518-29.
Symon, A., Williams, B., Adelasoye, Q. A., & Cheyne, H. (2015). Nocebo and the potential harm of 'high risk' labelling: a scoping review. Journal of Advanced Nursing, 71(7), pp. 1518-29. doi:10.1111/jan.12637.
Symon A, et al. Nocebo and the Potential Harm of 'high Risk' Labelling: a Scoping Review. J Adv Nurs. 2015;71(7):1518-29. PubMed PMID: 25702534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nocebo and the potential harm of 'high risk' labelling: a scoping review. AU - Symon,Andrew, AU - Williams,Brian, AU - Adelasoye,Qadir A, AU - Cheyne,Helen, Y1 - 2015/02/20/ PY - 2015/01/02/accepted PY - 2015/2/24/entrez PY - 2015/2/24/pubmed PY - 2016/3/29/medline KW - biopsychosocial model of health and illness KW - conceptual model KW - negative placebo KW - nocebo KW - nursing theory KW - psychosocial correlates SP - 1518 EP - 29 JF - Journal of advanced nursing JO - J Adv Nurs VL - 71 IS - 7 N2 - AIMS: A discussion of the existence, prevalence and characteristics of the nocebo effect in health care. BACKGROUND: There is increasing but inconsistent evidence for nocebo effects (the opposite of placebo). Causal mechanisms are believed to be similar to placebo (negative effects result from suggestions of negative clinical outcomes). Risk screening in health care may produce this unintended effect through labelling some patients as high risk. Given health care's almost universal coverage this potentially affects many people. DESIGN: Discussion paper following a scoping review of the existence and frequency of nocebo. DATA SOURCES: Literature databases (PsycINFO, MEDLINE, CCTR, CINAHL and EMBASE) searched from inception dates to 2013. IMPLICATIONS FOR NURSING: Significant empirical evidence indicates that negative beliefs may impact on health outcomes (incidence estimates range from 3-27%). The nocebo effect, rooted in the complex interplay between physiological functioning and social factors, appears significantly more common among women and where prior negative knowledge or expectations exist. Pre-existing psychological characteristics (anxiety, neuroses, panic disorder or pessimism) exacerbate it. CONCLUSION: While the placebo effect is well documented, there has been no systematic attempt to synthesize primary empirical research on the role of nocebo. It is possible that nocebo outcomes may be preventable through careful consideration of information provision and the prior identification of potentially high risk individuals. This paper summarizes the scale and importance of the nocebo effect, its distribution according to a range of social and clinical variables and its known relation to psychological precursors. It identifies important gaps in the research literature. SN - 1365-2648 UR - https://www.unboundmedicine.com/medline/citation/25702534/Nocebo_and_the_potential_harm_of_'high_risk'_labelling:_a_scoping_review_ L2 - https://doi.org/10.1111/jan.12637 DB - PRIME DP - Unbound Medicine ER -