Placebo/Nocebo Effect

Question 1

Positive non-specific or contextual effects of therapy

Answer 1

Placebo

Question 2

Negative non-specific or contextual effects of therapy

Answer 2

Nocebo

Question 3

Sham surgery, sham acupuncture, sham injections, and placebo topical therapies are more effective than

Answer 3

Pill placebos

Question 4

By comparison, there is a very small placebo response in

Answer 4

Dichotomous/binary outcomes

Question 5

Provides half or more of the medication benefit, especially for pain and depression

Answer 5

Placebo effect

Question 6

Up to 30% of patients discontinue placebo due to

Answer 6

Side effects

Question 7

The response to pain placebos is blocked by

Answer 7

naloxone (narcotic blocker) and rimonabant (cannabinoid blocker)

Question 8

Parkinson pill placebos and sham surgery cause changes in functional

Answer 8

MRI

Question 9

Cause changes in brain metabolic activity on functional MRI

Answer 9

Anti-depressant and pain placebos

Question 10

Decreased the placebo effect and increased the “nocebo” (rebound) effect

Answer 10

Higher anxiety

Question 11

COMT polymorphism with higher synaptic dopamine levels predicts “augmented” response of

Answer 11

Placebos

Question 12

Depression and anxiety lower the

Answer 12

Pain placebo response

Question 13

The pain nocebo response appears to be mediated by

Answer 13

Anxiety (treated by Valium) and CCK

Question 14

Really need a placebo arm, vs. an untreated arm, to be considered valid

Answer 14

Studies with a graded, subjective outcome

Question 15

May have less need for a placebo arm, as these are less influenced by placebo mechanisms

Answer 15

Studies with major objective, dichotomous outcomes (e.g. death)

Question 16

A placebo is unethical in a study when a credible placebo would be too risky. For example, in a

Answer 16

Sternotomy

Question 17

Used to distinguish between organic and psychogenic symptoms

Answer 17

Placebos

Question 18

The majority of medication side effects have nothing to do with the

Answer 18

Medication

Question 19

Is it ever appropriate to lie about what medication is patient is getting?

Answer 19

No

Question 20

Positive expectation-setting and positive/empathic demeanor are

Answer 20

Desireable

Question 21

Responsible for a large fraction of the placebo response

Answer 21

Physician-patient relationship