How do people with major depressive disorder respond to placebos?
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People with major depressive disorder (MDD) have shown varying responses to placebos over the years. In the 1980s, the response rate to placebo pills for MDD with psychotic features (MDD-Psy) was close to 0% . However, recent studies have reported an increase in placebo response rates, with around 33.6% to 39.9% of participants responding to placebos in the 2000s . Children and adolescents with MDD also exhibit a high response rate to placebos, ranging from 22% to 62% based on clinician ratings . Identifying potential placebo responders has been explored through various assessments, including clinical, behavioral, and electrophysiological variables, to predict depression severity and likelihood of improvement with placebos . Understanding these trends in placebo responses is crucial for interpreting the outcomes of clinical trials and optimizing treatment strategies for MDD.
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| Papers (5) | Insight |
|---|---|
37 Citations | Individuals with major depressive disorder who are younger, have lower baseline depression severity, and exhibit specific behavioral and electrophysiological markers are more likely to respond positively to placebos. |
| Children and adolescents with major depressive disorder show higher placebo response rates, ranging from 22% to 62% based on clinician ratings and 1% to 68% based on self-ratings. | |
| People with major depressive disorder showed increased response rates to placebos in recent trials compared to the 1980s, indicating a notable placebo effect in treating MDD with psychotic features. | |
| People with major depressive disorder with psychotic features showed increased response rates to placebos in randomized trials from the 1980s to the 2000s, indicating a notable placebo effect. | |
| Not addressed in the paper. |
Related Questions
Do people with depression respond more to placebo?5 answersIndividuals with depression have shown varying responses to placebos across different age groups and treatment modalities. Research indicates that the response rates to placebo pills in randomized controlled trials (RCTs) for major depressive disorder with psychotic features (MDD-Psy) have increased significantly over the years, from the 1980s to the 2000s. Moreover, older adults with treatment-resistant depression have exhibited a larger placebo response to sham repetitive transcranial magnetic stimulation (rTMS) compared to placebo pills. In children and adolescents with major depressive disorder, the response to placebos has been notably higher based on clinician ratings, exceeding that observed in adults. These findings suggest that individuals with depression may indeed respond more to placebos, with response rates varying across different age groups and treatment interventions.
What are the most promising biomarkers for major depressive disorder?5 answersThe most promising biomarkers for major depressive disorder (MDD) include LRFN5 and OLFM4, which have been implicated in MDD pathophysiology and show potential as diagnostic biomarkers. Another panel of biomarkers, L-selectin and an isoform of the Ras oncogene family, has been identified using proteomics and has shown promise in distinguishing MDD patients from healthy controls. Additionally, circulating CC chemokines, such as MIP-1α, MIP-1β, MCP-1, MCP-4, TARC, MDC, and Eotaxin-3, have been found to be potential biomarkers for diagnosing MDD. These biomarkers have shown significant differences in levels between MDD patients and healthy controls and have demonstrated good diagnostic performance in discriminating MDD patients from controls. Further research is needed to validate these biomarkers and determine their clinical utility in routine care.
Are antidepressants really effective in treating depression?5 answersAntidepressants are effective in treating depression, improving subjective and functional outcomes such as disability, work functioning, social functioning, well-being, and health-related quality of life (HRQoL) in depressed patients. However, the effectiveness of antidepressants can vary depending on the individual and the specific antidepressant used. Some studies suggest that certain antidepressants may be more effective than others, while others argue that there is no consistent difference in effectiveness between different antidepressants. It is important to note that the effectiveness of antidepressants is not solely determined by their chemical composition or the "chemical imbalance" explanation, but also by various factors such as patient characteristics, treatment adherence, and the presence of comorbidities. Overall, while antidepressants can be effective in treating depression, the choice of antidepressant and the individual response to treatment may vary.
Are the benefits of CBT just a placebo response?5 answersThe benefits of cognitive behavior therapy (CBT) for severe mental disorders are not just a placebo response. CBT has been shown to have potential benefits that have been undersold. Meta-analyses have overlooked critical study variables and there has been an overemphasis on comparing CBT to non-specific therapy controls. Placebo effects contribute to therapeutic responses, but they are not the sole explanation for the effectiveness of CBT. The placebo response complex is rooted in implicit memories of attachment and the concept of the benign superego. Additionally, cultural factors play a role in treatment responses, including the placebo response. While the placebo response can contribute to symptom reduction, it is unlikely to reduce underlying pathology. Therefore, the benefits of CBT extend beyond the placebo response and involve psychological mechanisms such as expectancy and conditioning, as well as the therapeutic relationship and empowerment.
What are the mechanisms by which placebos work?5 answersThe mechanisms by which placebos work involve a variety of factors and processes. Placebos are not simply inert substances, but rather a combination of sensory and social stimuli that create a therapeutic ritual. The placebo effect can be influenced by factors such as patient expectations, learning mechanisms, and the modulation of anxiety and reward systems in the brain. Different medical conditions and therapeutic interventions may involve different mechanisms of the placebo effect. Experimental evidence suggests that placebos can activate the same biochemical pathways as drugs, such as the endogenous opioid and endocannabinoid systems. The placebo effect can also be influenced by genetic variants and the functioning of specific neural networks in the brain. Overall, the study of the placebo effect provides insights into the complex interplay between psychology, biology, and social context in the healing process.
Are doctors right to use placebo effects?3 answersDoctors are divided on the use of placebo effects. Some argue that placebo-controlled trials have methodological advantages and that placebos can be a useful clinical tool in certain situations. However, others believe that the use of placebos is unethical and could harm the patient-health professional relationship. The debate centers around the potential harm that can be caused by the nocebo effect, where patients experience harmful effects from a physiologically inert treatment. Critics argue that it is against ethical principles to expose patients to placebos when valid therapeutic alternatives exist. In the future, it is likely that clinical trials for certain conditions, such as inflammatory bowel disease, will no longer use placebos and instead use non-inferiority trials with an active comparator.