The nocebo effect: impact, mitigation and prevention.
The nocebo effect is the induction of a symptom perceived as negative by sham treatment and/or by the suggestion of negative expectations. Recent evidence has mounted in support of the notion that the nocebo effect may be influenced by themes of language used by healthcare practitioners. The importance of the nocebo effect may be exaggerated in the chronic disease population, particularly those of advanced age. Using a clinical vignette to illustrate, this piece elucidates the nature of the nocebo effect in practice and explores potential areas of future consideration for physicians and physicians in training.