Recent data suggest that about 60% of depressed patients and more than 70% of healthy subjects agree to receive placebo as a first line treatment for depression. the effect of cultural background has not been studied.

To compare the viewpoint of healthy subjects from 3 different continents regarding the use of placebo for the treatment of depression.

1. 1) Investigate the willingness of subjects in each group to receive placebo in a case of depression in the future,

2. 2) Compare groups’ views regarding the possible effect of placebo use in clinical practice on doctor-patient relations and other ethical aspects.

350 health science students from three different countries (Romania, U.S.A., Israel) enrolled. All subjects were briefed thoroughly about the efficacy, potential benefits and limitations of placebo in treating depression and then completed a self-report questionnaire.

Both in Romania and U.S.A: 60% of the patients agreed to receive placebo as first line treatment and 70% agreed to receive placebo after a trail with SSRI. in Israel the tendency towards acceptance of placebo as first line treatment were higher (69%) (p > 0.05). in all groups over 70% of the subjects do not perceive prescribing placebo as a deceit or as an act that diminishes the patients' autonomy (p < 0.05).

The majority of participants agrees to receive placebo medication as a first line treatment, and do not feel that it will negatively affect their sense of autonomy or doctor-patient relationship. However, Cultural differences does exists and necessitate further research.