Non-Pharmacological Factors in Drug Therapy—The Inter-Action of Doctor, Patient and Tablet Appearance in the Treatment of Anxiety/Depressive Syndromes

Abstract

The degree to which placebo response is involved in an active treatment situation in normal clinical practice, and the factors comprising the placebo response, have been analyzed in a study on patients with anxiety/depressive syndromes. Four tablet preparations of different appearance but identical pharmacological activity were used over a three week period, and a comparison of therapeutic benefits between ‘treatments', doctors, and doctor—patient groupings was made, in addition to an analysis of the relationship of patients' self-assessments with their physicians' ratings. The results showed that although direct pharmacological effect was paramount in determining therapeutic outcome, detailed differences were related to various placebo factors. The similarity between physicians' and patients' ratings tends to decrease during the course of treatment, and possible reasons for this are reviewed in the light of previous work.