Abstract：
:Placebo effects are often attributed to clinical interactions and contextual factors that affect expectations of the patient about the treatment and result in symptom changes. The prevailing conceptualization consists of an undifferentiated placebo response that needs to be minimized in controlled investigations and maximized in clinical practice. However, treatment outcome is the cumulative result of the interaction of several classes of variables with a selected treatment: living conditions (housing, nutrition, work environment, social support), patient characteristics (age, sex, genetics, general health conditions, personality, well-being), illness features and previous therapeutic experience, self-management, and treatment setting (physician's attitude and attention, illness behavior). Such variables may be therapeutic or countertherapeutic, and are unlikely to be simply additive. In certain patients their interactive combination may lead to clinical improvement, whereas in other cases it may produce no effect, and, in a third group, it may lead to worsening of the condition. Maximizing patients' expectations does not necessarily result in sustained effects and, in due course, may actually lead to worsening of the condition (violation of expectations). In this paper, we outline a multifactorial conceptual model that may have implications for the design of clinical trials as well as for clinical practice, with special reference to psychopharmacology and psychotherapy. The effects of drug treatment may be potentiated by specific nonpharmacological treatment strategies, and this synergism may disclose significant differences against placebo. Medical outcomes may be unsatisfactory not because technical interventions are missing, but because our conceptual models and thinking are inadequate.
journal_name
Psychother Psychosomjournal_title
Psychotherapy and psychosomaticsauthors
Fava GA,Guidi J,Rafanelli C,Rickels Kdoi
10.1159/000480038subject
Has Abstractpub_date
2017-01-01 00:00:00pages
332-340issue
6eissn
0033-3190issn
1423-0348pii
000480038journal_volume
86pub_type
杂志文章abstract：BACKGROUND:The purpose of this study was to determine whether psychiatric disturbances, particularly somatization, and an increased number of traumatic and critical life events, which have been found in women with idiopathic chronic pelvic pain (ICPP), can also be observed in women with chronic pelvic pain and abdomina...
journal_title：Psychotherapy and psychosomatics
pub_type： 临床试验,杂志文章
doi：10.1159/000012318
更新日期：1999-03-01 00:00:00
abstract：BACKGROUND:Face-to-face psychological treatments have difficulty meeting today's growing mental health needs. For the highly prevalent posttraumatic stress (PTS) conditions, accumulating evidence suggests that writing therapy may constitute an efficient treatment modality, especially when administered through the Inter...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章,meta分析
doi：10.1159/000343131
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:The present study is part of a longitudinal study of recently resettled refugees with the aim of learning which factors in their daily life influence health as measured by self-report and stress-responsive hormones. METHODS:In a group of recently resettled refugees with a high incidence of posttraumatic str...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000064806
更新日期：2002-09-01 00:00:00
abstract：:Little is known about prognostic factors in the treatment of bulimic patients. In the context of an ongoing study we looked at 1-year symptomatic outcome of 37 outpatients fulfilling DSM-III-R criteria for bulimia nervosa in relation to a variety of measures at first assessment. These included multiple measures of dep...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000288530
更新日期：1991-01-01 00:00:00
abstract：:Phobic patients have been shown to be, on average, more hypnotizable than others. The essence of the phobic experience is not unlike that of the event of hypnosis, and the phobic experience might be a spontaneously occurring panic-filled trance-like or dissociative experience. This dissociation is viewed as a maladapt...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000287509
更新日期：1981-01-01 00:00:00
abstract：:Preliminary results are reported on the efficacy of a behaviorally oriented group therapy (n = 17) intended to improve coping with fear of long-term complications in patients with diabetes mellitus. Treatment consisted of exposure in imagination, relaxation training and analysis of dysfunctional health beliefs. Pre-, ...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000289009
更新日期：1995-01-01 00:00:00
abstract：BACKGROUND:Several studies suggested that the surroundings of chronic fatigue syndrome (CFS) patients are of importance in the persistence of complaints. Contrary to what was expected, participation in support groups has not led to clinical improvement. The purpose of the present study was to describe social support in...
journal_title：Psychotherapy and psychosomatics
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1159/000076455
更新日期：2004-05-01 00:00:00
abstract：OBJECTIVE:To study the effects of symptoms of posttraumatic stress disorder (PTSD), depression and dissociation as well as cumulative symptom load on language learning during the introduction phase in re-settled refugees. METHOD:Participants were re-settled refugees of Iraqi origin. They were assessed by means of a st...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000078849
更新日期：2004-09-01 00:00:00
abstract：BACKGROUND:In spite of the connection of alexithymic characteristics to many stress-related disorders, little is known about the effects of these characteristics on the self-perception of stress, which may have functional value in the regulation of daily behavior. The present study assessed the influence of alexithymic...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000012341
更新日期：1999-09-01 00:00:00
abstract：:The author describes the development of the research activity at a psychiatric clinic near Oslo, Modum Bads Nervesanatorium, a psychotherpeutic-oriented institution treating patients with neuroses, substance abuse and character disorders. In 1985 an institute for clinical research was built as an independent unit with...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000288367
更新日期：1990-01-01 00:00:00
abstract：:48 patients with alopecia areata, 30 with common baldness, 30 with fungal infections underwent the Paykel's Interview for recent life events. In the 6 months preceding onset, alopecic patients reported 123 events (mean = 2.56), patients with common baldness 22 events (mean = 0.73), patients with fungal infections 15 (...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000287786
更新日期：1984-01-01 00:00:00
abstract：:From the moment Max Hamilton started his psychiatric education, he considered psychometrics to be a scientific discipline on a par with biochemistry or pharmacology in clinical research. His clinimetric skills were in operation in the 1950s when randomised clinical trials were established as the method for the evaluat...
journal_title：Psychotherapy and psychosomatics
pub_type： 传,历史文章,杂志文章
doi：10.1159/000214441
更新日期：2009-01-01 00:00:00
abstract：:All patients with physical illness have an underlying fantasy concerning why they became sick. This fantasy can be elicited by the consulting psychiatrist and the treating physician. The meaning of the fantasy is consistent with the psychodynamic theory of human behavior. Also, once the fantasy is understood, it can b...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000287738
更新日期：1983-01-01 00:00:00
abstract：INTRODUCTION:Ketamine has shown rapid though short-lived antidepressant effects. The possibility of concerning neurobiological changes following repeated exposure to the drug motivates the development of strategies that obviate or minimize the need for longer-term treatment with ketamine. In this open-label trial, we i...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章,多中心研究
doi：10.1159/000457960
更新日期：2017-01-01 00:00:00
abstract：:It is generally conceded that allergic disorders occur in individuals who have a hereditary or congenital allergic constitution. Clinical symptoms of allergic disorders, however, often disappear due to changes of the individuals' life situations and/or their adaptive patterns. In a comparative study of allergic predis...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000287331
更新日期：1979-01-01 00:00:00
abstract：:Cognitive therapy includes a variety of methods. There are two main schools, a currently predominant American one, and an earlier European one. They give different emphasis to the concept of the evolution of human cognition. There is agreement on the particular significance of surmounting absolutist thinking. ...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000288357
更新日期：1990-01-01 00:00:00
abstract：BACKGROUND:While the extent of medical comorbidity in depressive illness is widely recognised, there have been few studies where objective and subjective assessment of comorbidity in chronic depression have been made. The aim of this study was to determine the extent and nature of medical comorbidity, in terms of both ...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000289144
更新日期：1997-01-01 00:00:00
abstract：:The Derogatis Stress Profile (DSP) is unique among the numerous measures of 'stress' in that it incorporates the interactional model of Lazarus and Folkman in a multidimensional structure. Derogatis has studied the psychometric properties of the DSP but its validity has not been demonstrated in the 'real world' nor ha...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000288555
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:Concerns about the risk-benefit ratio of treatment with antidepressants in the light of recent evidence pointing to a risk of suicide induction during the course of treatment with antidepressants. These concerns have led to a series of recent studies exploring national rates of suicide and correlating these ...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000112884
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:The consultation-liaison (C-L) psychiatrist is in an opportune position to undertake the tasks of education, training and assessment of performance as regards future physicians, psychiatrists, specialists in other branches and nurses. This paper describes the education and training programme in the Psychiatr...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000012397
更新日期：2000-07-01 00:00:00
abstract：:The concept of denial is important for the psychosomatic understanding of cardiovascular disease and treatment. This study evaluated denial using several psychometric assessment scales in patients referred for psychiatric evaluations prior to heart transplantation. Surviving patients who had a mean survival of more th...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000288421
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:The management of suicidal crisis remains a major issue for clinicians, driving the development of new strategies to improve suicide prevention. METHODS:We conducted a randomized controlled trial comparing a 7-week acceptance and commitment therapy (ACT) versus relaxation group, as adjunct to treatment as u...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章,随机对照试验
doi：10.1159/000488715
更新日期：2018-01-01 00:00:00
abstract：:Physiological parameters were studied over 4.5 months in normal high-school girls. One group frequently practised autogenic training (AT) whereas the other (control) did not. After 4.5 months the physiology of the AT, but not the control group had changed to some extent. The mean increase in finger skin temperature in...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000286991
更新日期：1976-01-01 00:00:00
abstract：:Eighty morbidly obese married women and 69 of their husbands completed a self-report measure of personal and marital adjustment before the women proceeded to gastric restriction surgery. Fifty-five women and 41 husbands repeated the measure 12 months after surgery, at which time the women had lost a mean of 35.4 kg. W...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000288550
更新日期：1991-01-01 00:00:00
abstract：:The political or ecological concept of quality of life refers to irreplaceable aspects of life. The health-related quality of life concept has the same impact of considering the irreplaceable (idiographic) aspects of treatment outcome in patients with chronic disorders. When comparing the different attempts to measure...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章,评审
doi：10.1159/000288637
更新日期：1993-01-01 00:00:00
abstract：BACKGROUND:The aim of this study was to investigate the clinical features of psychosomatic disorders in Japan. METHODS:A total of 1,432 outpatients (515 males and 917 females; 9-95 years of age, mean age 36) attending a psychosomatic clinic for the first time were assessed by the DSM-III-R or DSM-IV semistructured int...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000012258
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:Attention models view attention as having at least two components: endogenous attention defined as executive and directed by voluntary acts, and exogenous attention defined as automatic and directed by external stimulation. METHODS:Three studies (2 of our own) were designed to evaluate the decline of these ...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000116607
更新日期：2008-01-01 00:00:00
abstract：:An overview is presented of psychosomatic problems in women - the epidemiology, physiology and psychology. Surveys of sickness rates in women and psychological studies are used as a basis of speculation about higher female morbidity rates. Theories of psychosomatic illness, the somatic concomitants of hysteria and ale...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000287560
更新日期：1982-01-01 00:00:00
abstract：BACKGROUND:Antidepressant use is highly prevalent. Research has mainly focused on efficacy during short periods of use for depression and anxiety. There is a relative paucity of data regarding the frequency of long-term use. METHODS:To determine the prevalence and possible increase of long-term use of antidepressants ...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000480456
更新日期：2017-01-01 00:00:00
abstract：:The studies described in this paper provide evidence for the importance of social factors in determining the response of the hypothalamic-pituitary-adrenal (H-P-A) system to stress. The presence of familiar social partners can reduce or eliminate the cortisol response to either loss of a significant social relationshi...
journal_title：Psychotherapy and psychosomatics
pub_type： 杂志文章
doi：10.1159/000288677
更新日期：1993-01-01 00:00:00
