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Placebo effects: a new paradigm and relevance to psychiatry

Published online by Cambridge University Press:  02 January 2018

Daniel McQueen  and
Paul St John Smith
Daniel McQueen
Affiliation:
Royal Free Hampstead NHS Trust, London, UK, email [email protected]
Paul St John Smith
Affiliation:
Hertfordshire Partnership Foundation Trust, UK, email [email protected]
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Systematic evaluations show that placebo treatments can have large effects, sometimes larger than those of ‘evidence-based treatments’. This is the ‘efficacy paradox’. The neurobiology of placebo effects is being mapped out. Placebo effects are no less real or, in some illnesses, clinically important than the effects of direct biomechanical or pharmacological interventions. The technical model of medicine seeks impersonal technologies that can be applied independently of context and person. This approach has had spectacular success in the treatment of disease but meaning, cultural context, interpersonal effects, personal preferences and values are enormously important in the treatment of illness. The study of placebo reveals aspects of the biology of interpersonal relationships and the social environment. The evidence demonstrates that interpersonal healing (sometimes called placebo) in illness is just as real, scientific and biological as technological healing. This is a paradigm shift.

Type
Guest editorial
Information
International Psychiatry , Volume 9 , Issue 1 , February 2012 , pp. 1 - 3
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
Copyright © Royal College of Psychiatrists 2012

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