The placebo problem.

Presenter Geoff Watts explores the uses and implications of the nocebo effect in current medical practise. Nocebo is the placebo effect’s malign counterpart, in which anticipation of negative effects – often due to the way a medical diagnosis is presented to a patient – changes the body’s sensations in a negative way. Professor Ted Kaptchuk talks about his experiments into placebo/nocebo effects. Watts interviews Professor Irene Tracey about her research into placebo/nocebo drugs treatments. Watts explores the role that information on drugs packaging takes in triggering placebo/nocebo responses. Professor Keith Petrie discusses this further, and debates the perceived reliability of the information given with branded drugs compared to generic drugs. Director, Centre for Psychosomatic Medicine at Universität Tübingen Professor Dr Paul Enck discusses the phenomenon of reattributing everyday side effects to the perceived side effects of a particular drug treatment. Petrie discusses the effect on individuals of national health scares involving widely used drugs treatments, referring to a case in New Zealand involving GlaxoSmithKline’s Eltroxin. Watts interviews Tracey about her research into brain patterns of placebo/nocebo responses using FMRI scanning on the Descending Pain Modulatory System. Professor Fabrizio Benedetti discusses the role of the chemical cholecystokinin (CCK) in the nocebo response. Enck discusses unlikelihood of a single mechanism that defines placebo and nocebo responses. Watts presents the ethical debates connected to researching placebo/nocebo effects. The panel discuss the medical-ethical concept of authorised deception. Professor Paul Dieppe explains the behavioural methods of Validation and Invalidation used by medical professionals. The panel discuss the notion of healing in medicine. Dr Mark Porter and Kaptchuk discuss the different behavioural approaches GPs can take to health concerns voiced by patients.