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zoobyshoe
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A sugar pill's magic lies in deception—the patient must believe she's getting the real thing. Right?
Wrong, according to a groundbreaking study published in PLoS One. Researchers asked patients suffering from irritable bowel syndrome (a common, hard-to-treat disorder with mostly subjective symptoms) to take placebo pills twice a day. They told participants that the pills had no active ingredients, but—this is key—they also explained that placebos can improve IBS symptoms "through mind-body self-healing processes."
By the end of the three-week trial, 59 percent of pill takers (vs. 35 percent of controls) reported adequate relief. The placebo also doubled the degree of symptom reduction and improvement in quality of life.
http://www.psychologytoday.com/collections/201201/the-placebo-effect/wising-dummy-pills
The actual study:
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0015591
Methods
Two-group, randomized, controlled three week trial (August 2009-April 2010) conducted at a single academic center, involving 80 primarily female (70%) patients, mean age 47±18 with IBS diagnosed by Rome III criteria and with a score ≥150 on the IBS Symptom Severity Scale (IBS-SSS). Patients were randomized to either open-label placebo pills presented as “placebo pills made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes” or no-treatment controls with the same quality of interaction with providers. The primary outcome was IBS Global Improvement Scale (IBS-GIS). Secondary measures were IBS Symptom Severity Scale (IBS-SSS), IBS Adequate Relief (IBS-AR) and IBS Quality of Life (IBS-QoL).
Findings
Open-label placebo produced significantly higher mean (±SD) global improvement scores (IBS-GIS) at both 11-day midpoint (5.2±1.0 vs. 4.0±1.1, p<.001) and at 21-day endpoint (5.0±1.5 vs. 3.9±1.3, p = .002). Significant results were also observed at both time points for reduced symptom severity (IBS-SSS, p = .008 and p = .03) and adequate relief (IBS-AR, p = .02 and p = .03); and a trend favoring open-label placebo was observed for quality of life (IBS-QoL) at the 21-day endpoint (p = .08).
Conclusion
Placebos administered without deception may be an effective treatment for IBS. Further research is warranted in IBS, and perhaps other conditions, to elucidate whether physicians can benefit patients using placebos consistent with informed consent.