Nocebo Effect

MIND OVER MATTER: How expecting the worse can hurt your health. Call it the Nocebo Effect

2:08 p.m. 10/30/2007

Oct 30, 2007 (The Miami Herald - McClatchy-Tribune Information Services via COMTEX) -- With Halloween's penchant for ghouls and gore, "scared to death" often comes to mind. But can the mind actually influence life and death -- or at least our well-being? Medical science is asking the same question.

Consider the case of Sam Londe. In 1974, Dr. Clifton Meador, a Nashville physician, treated him for cancer of the esophagus, considered fatal back then. Londe died a few weeks later, but an autopsy revealed that his esophagus was fine. He had a few cancerous spots on his liver and one on his lung, but not enough to kill him.

Three decades later Meador told the Discovery Health Channel: "He died with cancer, but not from cancer. . . . I thought he had cancer. He thought he had cancer. Everybody around him thought he had cancer. Did I remove hope in some way?"

Though we'll never know for sure, Londe could have fallen victim to the nocebo phenomenon. Coined in 1961, "it's sort of a nasty counterpart of the placebo phenomenon," says Robert Hahn, a senior scientist at the Centers for Disease Control and Prevention.

With a placebo, a harmless substance is given to patients in medical studies to test the efficacy of a drug. Patients normally expect a positive outcome. With the nocebo effect, people expect something bad to occur, developing symptoms after learning about painful side effects of medication.

"People get worse because they believe they'll get worse," says Dr. Julio Licinio, chairman of the Department of Psychiatry and Behavioral Sciences at the University of Miami. "It's almost like a negative self-fulfilling prophecy."