Positive Expectations and Depression

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Positive thinking may help some depressed patients after all, according to a new study on the placebo effect in medical research.

Over the past three decades, researchers say, there’s been a sharp rise in patients’ positive response to placebos – the fake medication given to some study participants who think it’s actual medicine.

The latest research, from UCLA psychiatrists, say a very simple conclusion may be at the root of the effectiveness of placebos in treating depressive disorder.

“In short,” said Andrew Leuchter, the study’s first author and a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, “if you think a pill is going to work, it probably will.”

In their study of 88 depressed people between 18 and 65, the researchers looked at three kinds of treatment: one was “supportive care” from a therapist who provided emotional support and encouragement without offering solutions to the patient’s issues. The other two treatments also offered supportive care, but with either real medicine or placebos.

Incorporating either kind of pill, whether real or fake, led to better outcomes than supportive care alone. And what’s more, the researchers found, the effectiveness of the placebo treatment depended on how high patients’ expectations were before they began treatment. People who believed that medication could help them were likelier to respond to placebos. On the other hand, actual medicine worked for those who had both low and high expectations.

“Our study indicates that belief in ‘the power of the pill’ uniquely drives the placebo response, while medications are likely to work regardless of patients’ belief in their effectiveness,” Leuchter said. However, he added, that doesn’t mean real medicine is perfect. “Interestingly, while we found that medication was more effective than placebo, the difference was modest.”

The study was published in the British Journal of Psychiatry.