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• W2761569307 abstract "While for adults, a plurality of studies examines placebo responses and potentialmoderators in antidepressant trials, comparable investigations in pediatric and geriatric patientsare scarce. This is especially problematic since the efficacy and safety of antidepressants iscontroversial in these sensitive populations: effect sizes are small and severe side effects suchas an increased risk of suicidal thoughts and behavior have been reported. Here, it has beenhypothesized that the lack of a consistent significant benefit of antidepressants over placebocould be associated with an increased response to placebo. Therefore, it is worth consideringwhether the potential of placebos can be harnessed without undermining patients’ autonomythrough deception.The emphasis of the current dissertation was twofold: first, to investigate the efficacyof placebos and potential moderators in pediatric and geriatric patients. Second, toexperimentally test the necessity of deception. For this reason, two different statisticalapproaches were indicated. For the first aim, a meta-analytic approach was applied in order toassess differences between antidepressant and placebo interventions in pediatric majordepressive disorder (MDD), anxiety disorders, obsessive-compulsive disorder, andposttraumatic stress disorder (Locher, et al., 2017; Study I), as well as in geriatric MDD,dysthymia and minor depression (Locher et al., 2015; Study II) along with variation in placeboresponses and moderators. For the second goal, a basic research approach was chosen in orderto compare the effects of openly prescribed placebos with a deceptive placebo administrationin a standardized heat pain experiment with healthy participants (Locher, Frey Nascimento,Kossowsky, Meyer, & Gaab, 2017; Study III). Here, basic research represents an excellent wayto experimentally compare these treatments in accordance with ethical principles.The meta-analyses revealed that antidepressants are more effective than placebo attreating MDD in children and adolescents (Hedges’ g = 0.20; Study I), as well as in elderlypeople (Hedges’ g = 0.37; Study II). However, the effects were only small and did not reachthe proposed cut-off for clinical significance. Also, placebo responses in depressed youth(Hedges’ g = 1.57; Study I), as well as in depressed elderly (Hedges’ g = 0.96; Study II) weresignificant and substantial. Findings of the heat pain experiment with healthy participantsrevealed that open-label placebos do not differ in their effects from deceptive placebos insubjective outcomes (i.e., heat pain intensity ratings: p = .136 and heat pain unpleasantnessratings: p = .481; Study III).Placebo responses are large and meaningful in children, adolescents and elderly peoplewith depression. Pediatric as well as geriatric patients seem to respond well to clinician contactthat promotes the therapeutic alliance and other common factors such as the patients’expectations and hopes of improvement. Furthermore, the ubiquitously assumed necessity ofconcealment in placebo administration is questioned and new ways in order to harness thepotential of placebos should be considered." @default.
• W2761569307 created "2017-10-20" @default.
• W2761569307 creator A5018484734 @default.
• W2761569307 date "2017-01-01" @default.
• W2761569307 modified "2023-09-25" @default.
• W2761569307 title "Placebos and their consequences in clinical and basic research : effects and possible ways to harness them" @default.
• W2761569307 doi "https://doi.org/10.5451/unibas-006736439" @default.
• W2761569307 hasPublicationYear "2017" @default.
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