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Placebo Response in Schizophrenic Outpatients

Placebo Response in Schizophrenic Outpatients Abstract Introduction Placebo response has become a focus of much interest in psychiatric treatment. Not only have the values of the placebo in therapy and research been discussed, but its negative effects as well. Reports are present of placebos having emphatic adverse and structural effects on patients.1 For example, dermatitis medicamentosa has been associated with placebo ingestion in verified cases.2 In outpatient psychotherapy Fischer and Dlin found that when placebo was added to the treatment, the results were often poorer than when psychotherapy was used alone.3 The demonstrated potency of the placebo has led to a consideration of the placebo reactor. Some effort has been made to define the kind of person who has a marked or significant response to a placebo. In one study the investigators were able to distinguish postoperative placebo reactors on Rorschach responses.4 The reactors in this study appear to be “individuals who References 1. Our own unpublished findings have shown a significant correlation between placebo response and authoritarian attitudes in these patients. 2. Zucker, A. H.; Machlin, S. D., and Scott, W.: An Evaluation of Meprobamate in Opiate Withdrawal , Am. J. Psychiat. 115:254-255, 1958. 3. Wolf, S., and Pinsky, R. H.: Effects of Placebo Administration and Occurrence of Toxic Reactions , J.A.M.A. 155:339-341, 1954.Crossref 4. Fischer, H. k., and Dlin, B. M.: The Dynamics of Placebo Therapy: A Clinical Study , Am. J. M. Sc. 232:504-512, 1956.Crossref 5. Lasagna, L.; Mosteller, F.; von Felsinger, J. M., and Beecher, H. K.: A Study of the Placebo Response , Am. J. Med. 16:770-779, 1954.Crossref 6. von Felsinger, J. M.; Lasagna, L., and Beecher, H. K.: Drug-Induced Mood Changes in Man , J. A.M.A. 157:1113-1119, 1955.Crossref 7. von Meduna, L. J.: Carbon Dioxide Therapy: A Neurophysiological Treatment of Nervous Disorders , Springfield, Ill. Charles C Thomas, Publisher, 1950. 8. Wolf, S.: Effects of Suggestion and Conditioning on the Action of Chemical Agents in Human Subjects—The Pharmacology of Placebos , J. Clin. Invest. 29:100-109, 1950.Crossref 9. Hill, H. E.; Belleville, R. E., and Wikler, A.: Motivational Determinants in Modification of Behavior by Morphine and Pentobarbital , A.M.A. Arch. Neurol. & Psychiat. 77:28-35, 1957. 10. Gliedman, L. H.; Nash, E. H., Jr.; Imber, S. D.; Stone, A. R., and Frank, J. D.: Reduction of Symptoms by Pharmacologically Inert Substances and by Short-Term Psychotherapy , A.M.A. Arch. Neurol. & Psychiat. 79:345-351, 1958. 11. Tibbetts, R. W., and Hawkings, J. R.: The Placebo Response , J. Ment. Sc. 102:60-66, 1956. 12. Rosenthal, D., and Frank, J. D.: Psychotherapy and the Placebo Effect , Psychol. Bull. 53:294-302, 1956. 13. Gliedman, L. H.; Gantt, W. H., and Teitelbaum, H. A.: Some Implications of Conditional Reflex Studies of Placebo Research , Am. J. Psychiat. 113:1103-1107, 1957. 14. Lorr, M.: A Multidimensional Scale for Rating Psychiatric Patients: Hospital Forum , Veterans Admin. Tech. Bull. TB 10-507 , 6:1-44, 1953. 15. Freedman, N.; Engelhardt, D. M.; Hankoff, L. D.; Glick, B.S.; Kaye, H.; Buchwald, J., and Stark, P.: Drop-Out from Outpatient Psychiattric Treatment: Personality and Situational Determinants , A.M.A. Arch. Neurol. & Psychiat. 80:657-666, 1958. 16. Hankoff, L. D.: Freedman, N., and Engelhardt, D. M.: The Prognostic Value of Placebo Response , Am. J. Psychiat. 115:549-550, 1958. 17. Kahn, R. L., and Fink, M.: Changes in Language During Electroshock Therapy , in Psychopathology of Communication , edited by P. H. Hoch and J. Zubin, New York, Grune & Stratton, Inc., 1958, Chap. 9. 18. Weinstein, E. A.; Linn, L., and Kahn, R. L.: Psychosis During Electroshock Therapy: Its Relation to the Theory of Shock , Am. J. Psychiat. 109:22-26, 1952. 19. Hollingshead, A. de B., and Redlich, F. C.: Social Class and Mental Illness , New York, John Wiley & Sons, Inc., 1958. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of General Psychiatry American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0375-8532
DOI
10.1001/archpsyc.1960.03590070035005
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Abstract

Abstract Introduction Placebo response has become a focus of much interest in psychiatric treatment. Not only have the values of the placebo in therapy and research been discussed, but its negative effects as well. Reports are present of placebos having emphatic adverse and structural effects on patients.1 For example, dermatitis medicamentosa has been associated with placebo ingestion in verified cases.2 In outpatient psychotherapy Fischer and Dlin found that when placebo was added to the treatment, the results were often poorer than when psychotherapy was used alone.3 The demonstrated potency of the placebo has led to a consideration of the placebo reactor. Some effort has been made to define the kind of person who has a marked or significant response to a placebo. In one study the investigators were able to distinguish postoperative placebo reactors on Rorschach responses.4 The reactors in this study appear to be “individuals who References 1. Our own unpublished findings have shown a significant correlation between placebo response and authoritarian attitudes in these patients. 2. Zucker, A. H.; Machlin, S. D., and Scott, W.: An Evaluation of Meprobamate in Opiate Withdrawal , Am. J. Psychiat. 115:254-255, 1958. 3. Wolf, S., and Pinsky, R. H.: Effects of Placebo Administration and Occurrence of Toxic Reactions , J.A.M.A. 155:339-341, 1954.Crossref 4. Fischer, H. k., and Dlin, B. M.: The Dynamics of Placebo Therapy: A Clinical Study , Am. J. M. Sc. 232:504-512, 1956.Crossref 5. Lasagna, L.; Mosteller, F.; von Felsinger, J. M., and Beecher, H. K.: A Study of the Placebo Response , Am. J. Med. 16:770-779, 1954.Crossref 6. von Felsinger, J. M.; Lasagna, L., and Beecher, H. K.: Drug-Induced Mood Changes in Man , J. A.M.A. 157:1113-1119, 1955.Crossref 7. von Meduna, L. J.: Carbon Dioxide Therapy: A Neurophysiological Treatment of Nervous Disorders , Springfield, Ill. Charles C Thomas, Publisher, 1950. 8. Wolf, S.: Effects of Suggestion and Conditioning on the Action of Chemical Agents in Human Subjects—The Pharmacology of Placebos , J. Clin. Invest. 29:100-109, 1950.Crossref 9. Hill, H. E.; Belleville, R. E., and Wikler, A.: Motivational Determinants in Modification of Behavior by Morphine and Pentobarbital , A.M.A. Arch. Neurol. & Psychiat. 77:28-35, 1957. 10. Gliedman, L. H.; Nash, E. H., Jr.; Imber, S. D.; Stone, A. R., and Frank, J. D.: Reduction of Symptoms by Pharmacologically Inert Substances and by Short-Term Psychotherapy , A.M.A. Arch. Neurol. & Psychiat. 79:345-351, 1958. 11. Tibbetts, R. W., and Hawkings, J. R.: The Placebo Response , J. Ment. Sc. 102:60-66, 1956. 12. Rosenthal, D., and Frank, J. D.: Psychotherapy and the Placebo Effect , Psychol. Bull. 53:294-302, 1956. 13. Gliedman, L. H.; Gantt, W. H., and Teitelbaum, H. A.: Some Implications of Conditional Reflex Studies of Placebo Research , Am. J. Psychiat. 113:1103-1107, 1957. 14. Lorr, M.: A Multidimensional Scale for Rating Psychiatric Patients: Hospital Forum , Veterans Admin. Tech. Bull. TB 10-507 , 6:1-44, 1953. 15. Freedman, N.; Engelhardt, D. M.; Hankoff, L. D.; Glick, B.S.; Kaye, H.; Buchwald, J., and Stark, P.: Drop-Out from Outpatient Psychiattric Treatment: Personality and Situational Determinants , A.M.A. Arch. Neurol. & Psychiat. 80:657-666, 1958. 16. Hankoff, L. D.: Freedman, N., and Engelhardt, D. M.: The Prognostic Value of Placebo Response , Am. J. Psychiat. 115:549-550, 1958. 17. Kahn, R. L., and Fink, M.: Changes in Language During Electroshock Therapy , in Psychopathology of Communication , edited by P. H. Hoch and J. Zubin, New York, Grune & Stratton, Inc., 1958, Chap. 9. 18. Weinstein, E. A.; Linn, L., and Kahn, R. L.: Psychosis During Electroshock Therapy: Its Relation to the Theory of Shock , Am. J. Psychiat. 109:22-26, 1952. 19. Hollingshead, A. de B., and Redlich, F. C.: Social Class and Mental Illness , New York, John Wiley & Sons, Inc., 1958.

Journal

A.M.A. Archives of General PsychiatryAmerican Medical Association

Published: Jan 1, 1960

References