Paul Enck Professor, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen
What´s in the placebo research box? Past achievements and future tasks!
Introduction: To identify topics of research that have been neglected, undervalued or overseen in the past two decades of placebo/nocebo research, a highly specialized literature database containing more than 3,500 papers on the placebo or nocebo effects or response was screened for papers covering placebo effects in nutrition, sports medicine, physical therapy and psychotherapy, for papers covering gender, age, and culture as influencing factors, for articles dealing with long-term outcome, multi-modality, and for papers related to technical (eHealth, mHealth) aspects of placebo effects.
Results: While placebo research has gained substantial progress over the last two decades, it has not resolved all its puzzles, it has ignored some obvious and some less obvious facets of the placebo topic, and it has overlooked that during these years, medicine has further developed and progressed, as has the doctor-patient relationship and the social environment in which this communication happens.
Conclusion: The biggest threat for placebo research is that it may outdate itself by declaring all and everything as a placebo effect even if there may be better terms and concepts (e.g. patient expectations, doctor-patient communication, empathy), and by ignoring that medicine continuously changes its face, for patients as well as for clinical researchers. Its biggest opportunity is the fact that it – as no other topic in medicine – requires both medical and psychological experts for its exploration, and to stay updated.
Prof. Dr. Paul Enck, Director of Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany. His main interests are gut functions in health and disease, including functional and inflammatory bowel disorders, the role of the gut microbiota, regulation of eating and food intake and its disorders, of nausea, vomiting and motion sickness, and the psychophysiology and neurobiology of the placebo response, with specific emphasis on gender differences. He has published more than 220 original data papers in scientific, peer-reviewed journals, and more than 250 review articles and book chapters. He is board member/treasurer of the European Society of Neurogastroenterology and Motility, the German Society of Neurogastroenterology and Motility, and The Society of Interdisciplinary Placebo Studies, and has served as reviewer for many national and international journals and grant agencies.