To evaluate the induction methods, symptom domains, and potential moderators of nocebo responses in patients with long-term conditions (LTCs) to inform strategies for reducing nocebo-related harm.
Key Findings:
Thirteen studies were included, covering conditions such as chronic pain, asthma, Parkinson's disease, cancer, and dermatology.
Nocebo effects were commonly induced through negative verbal suggestion or negatively framed clinical information.
Increased subjective symptom intensity and alterations in physiological markers were observed, along with brain activation patterns linked to expectancy.
Evidence for neurological symptoms was mixed, and psychological moderators were inconsistently measured.
Interpretation:
Individuals with long-term conditions can exhibit significant nocebo responses, emphasizing the critical role of communication in clinical settings.
Limitations:
Substantial heterogeneity in induction procedures and outcome measures across studies.
Inconsistent measurement of psychological moderators and varying definitions of outcomes.
Conclusion:
Improving communication strategies and standardizing induction and measurement approaches are essential to mitigate nocebo responses and enhance treatment engagement in LTC management.
