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Placebo effects in randomized trials of pharmacological and neurostimulation interventions for mental disorders: An umbrella review.
Huneke, Nathan T M; Amin, Jay; Baldwin, David S; Bellato, Alessio; Brandt, Valerie; Chamberlain, Samuel R; Correll, Christoph U; Eudave, Luis; Garner, Matthew; Gosling, Corentin J; Hill, Catherine M; Hou, Ruihua; Howes, Oliver D; Ioannidis, Konstantinos; Köhler-Forsberg, Ole; Marzulli, Lucia; Reed, Claire; Sinclair, Julia M A; Singh, Satneet; Solmi, Marco; Cortese, Samuele.
Afiliação
  • Huneke NTM; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. n.huneke@soton.ac.uk.
  • Amin J; Southern Health NHS Foundation Trust, Southampton, UK. n.huneke@soton.ac.uk.
  • Baldwin DS; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
  • Bellato A; Southern Health NHS Foundation Trust, Southampton, UK.
  • Brandt V; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
  • Chamberlain SR; Southern Health NHS Foundation Trust, Southampton, UK.
  • Correll CU; University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
  • Eudave L; School of Psychology, University of Nottingham Malaysia, Semenyih, Malaysia.
  • Garner M; Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
  • Gosling CJ; Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
  • Hill CM; Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany.
  • Hou R; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
  • Howes OD; Southern Health NHS Foundation Trust, Southampton, UK.
  • Ioannidis K; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Köhler-Forsberg O; Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
  • Marzulli L; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
  • Reed C; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA.
  • Sinclair JMA; Faculty of Education and Psychology, University of Navarra, Pamplona, Spain.
  • Singh S; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
  • Solmi M; Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
  • Cortese S; School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
Mol Psychiatry ; 2024 Jun 24.
Article em En | MEDLINE | ID: mdl-38914807
ABSTRACT
There is a growing literature exploring the placebo response within specific mental disorders, but no overarching quantitative synthesis of this research has analyzed evidence across mental disorders. We carried out an umbrella review of meta-analyses of randomized controlled trials (RCTs) of biological treatments (pharmacotherapy or neurostimulation) for mental disorders. We explored whether placebo effect size differs across distinct disorders, and the correlates of increased placebo effects. Based on a pre-registered protocol, we searched Medline, PsycInfo, EMBASE, and Web of Knowledge up to 23.10.2022 for systematic reviews and/or meta-analyses reporting placebo effect sizes in psychopharmacological or neurostimulation RCTs. Twenty meta-analyses, summarising 1,691 RCTs involving 261,730 patients, were included. Placebo effect size varied, and was large in alcohol use disorder (g = 0.90, 95% CI [0.70, 1.09]), depression (g = 1.10, 95% CI [1.06, 1.15]), restless legs syndrome (g = 1.41, 95% CI [1.25, 1.56]), and generalized anxiety disorder (d = 1.85, 95% CI [1.61, 2.09]). Placebo effect size was small-to-medium in obsessive-compulsive disorder (d = 0.32, 95% CI [0.22, 0.41]), primary insomnia (g = 0.35, 95% CI [0.28, 0.42]), and schizophrenia spectrum disorders (standardized mean change = 0.33, 95% CI [0.22, 0.44]). Correlates of larger placebo response in multiple mental disorders included later publication year (opposite finding for ADHD), younger age, more trial sites, larger sample size, increased baseline severity, and larger active treatment effect size. Most (18 of 20) meta-analyses were judged 'low' quality as per AMSTAR-2. Placebo effect sizes varied substantially across mental disorders. Future research should explore the sources of this variation. We identified important gaps in the literature, with no eligible systematic reviews/meta-analyses of placebo response in stress-related disorders, eating disorders, behavioural addictions, or bipolar mania.

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article