Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T07:32:45.555Z Has data issue: false hasContentIssue false
  • English
  • Français

The placebo: from specificity to the non-specific and back1

Published online by Cambridge University Press:  09 July 2009

Michael Shepherd
Michael Shepherd*
Affiliation:
Institute of Psychiatry, London
*
2Address for correspondence: Professor Michael Shepherd, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

A brief historical outline is provided of the concept of specificity in biology and medicine. The advent of scientifically based therapeutics, and especially clinical pharmacology, has directed increasing attention to the role of non-specific factors in the field of mental disorders. The actions and effects of placebos are discussed in relation to the specific/non-specific dichotomy with particular reference to both pharmacological and psychological modes of treatment.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 3 , August 1993 , pp. 569 - 578
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

Based on a lecture delivered at the 50th Anniversary International Meeting of the American Psychosomatic Society in New York City, 1992.

References

Alexander, F. & Szasz, T. S. (1952). The psychosomatic approach in medicine. In Dynamic Psychiatry (ed. Alexander, F. and Ross, H.), pp. 369–400. University of Chicago Press: Chicago.Google Scholar
Attardi, G. & Sperry, R. (1963). Preferential selection of central pathways by regenerating optic fibers. Experimental Neurology 7, 46–64.CrossRefGoogle ScholarPubMed
Beecher, H. K. (1955). The powerful placebo. Journal of the American Medical Association 159, 1602–1606.Google Scholar
Black, I. B. (1991). Information in the Brain: A Molecular Perspective. MIT Press: Cambridge, Mass.Google Scholar
Boyle, R. (1685). Of the Reconcileableness of Specifick Medicines to the Corpuscular Philosophy. S. Smith: London.Google Scholar
Brill, H. & Patton, R. E. (1955). Analysis of population reduction in New York State mental hospitals during the first four years of large-scale therapy with psychotropic drugs. American Journal of Psychiatry 116, 495–508.Google Scholar
Brody, H. (1977). Placebos and the Philosophy of Medicine. University of Chicago Press: Chicago.Google Scholar
Brody, H. (1985). Placebo effect: an examination of Grünbaum's Definition. In Placebo: Theory, Research and Mechanisms (ed. White, L., Tursky, B. and Schwartz, G. F.), pp. 37–58. Guildford Press: New York.Google Scholar
Brody, H. & Waters, D. B. (1980). Diagnosis is treatment. Journal of Family Practice 10, 445–449.Google Scholar
Bruner, J. (1990). Acts of Meaning, pp. 20–21. Harvard University Press: Cambridge, Mass.Google Scholar
Cheney, C. O. & Drewry, P. H. (1938). Results of non-specific treatment in dementia praecox. American Journal of Psychiatry 95, 203–208.CrossRefGoogle Scholar
Clark, A. J. (1937). General pharmacology. In Handbuch der experimentellen Pharmakologie, Ergänzungswerk, vol. 4. (ed. Heffter, A.). pp. 25–41. J. Springer: Berlin.Google Scholar
Cook, L. C. (1959). Comparison of abnormal behavioural states induced by psychotropic drugs in animals and man (Discussion). In Neuro-psychopharmacology (ed. Bradley, P., Deniker, P. and Radouco-Thomas, C.), p. 123. Elsevier: Amsterdam.Google Scholar
Downing, R. W. & Rickels, K. (1978). Non-specific factors and their interaction with psychological treatment in pharmacotherapy. In Psychopharmacology: A Generation of Progress (ed. Lipton, M. A., Di Mascop, A. and Killam, K. F.), pp. 1419–1428. Raven Press: New York.Google Scholar
Eccles, J. (1959). Discussion in Neuro-Psychopharmacology (ed. Bradley, P., Deniker, P. and Radrico-Thomas, C.), pp. 57–61. Elsevier: Amsterdam.Google Scholar
Eisenberg, L. (1984). The ambiguities of psychosomatic medicine. Journal of Psychosomatic Obstetrics and Gynaecology 3, 115–127.Google Scholar
Elkin, I., Parloff, M. B., Hadley, S. W. & Autry, J. H. (1988 a). NIMH treatment of depression collaborative research program. Archives of General Psychiatry 42, 305–316.Google Scholar
Elkin, I., Pilkonis, P. A., Docherty, J. P. & Sotsky, S. M. (1988 b). Conceptual and methodological issues in comparative studies of psychotherapy and pharmacotherapy, II: nature and timing of treatment effects. American Journal of Psychiatry 145, 1070–1076.Google Scholar
Elkin, I., Pilkonis, P. A., Docherty, J. P. & Sotsky, S. M. (1988 c). Conceptual and methodological issues in comparative studies of psychotherapy and pharmacotherapy, I: active ingredients and mechanisms of change. American Journal of Psychiatry 145, 909–917.Google Scholar
Fisher, R. A. (1930). The Genetic Theory of Natural Selection. Clarendon Press: Oxford.Google Scholar
Fisher, S. (1970). Non-specific factors as determinants of behavioural response to drugs. In Clinical Handbook of Psychopharmacology (ed. Shader, R. I.), pp. 17–39. Science House: New York.Google Scholar
Frank, J. D. (1983). The placebo is psychotherapy. Behavioural and Brain Sciences 6, 291–292.CrossRefGoogle Scholar
Frank, J. D. (1986). Psychotherapy – the transformation of meanings. Journal of the Royal Society of Medicine 74, 241–246.Google Scholar
Frank, J. D. (1989). Non-specific aspects of treatment: the view of a psychotherapist. In Non-Specific Aspects of Treatment (ed. Shepherd, M. and Sartorius, N.), pp. 95–114. Huber: Toronto.Google Scholar
Galdston, I. (1941–1942). The concept of the specific in medicine. Transactions of the College of Physicians of Philadelphia, 4th series, 9, 25–34.Google Scholar
Garattini, S. & Mennini, T. (1986). Critical notes on the specificity of drugs in the study of metabolism and functions of brain monoamines. Unpublished manuscript.Google Scholar
Grünbaum, A. (1981). The placebo concept. Behaviour Research and Therapy 19, 157–167.Google Scholar
Hahn, A. & Kleinman, A. (1983). Belief as pathogen, belief as medicine: ‘voodoo death’ and the ‘placebo phenomenon’ in anthropological perspective. Medical Anthropology Quarterly 14, 3–19.Google Scholar
Harris, T. & Brown, G. W. (1989). The LEDS findings in the context of other research: an overview. In Life Events and Illness (ed. Brown, G. W. and Harris, T. O.), pp. 57–94. Huber: Toronto.Google Scholar
Hill, A. B. (1971). Principles of Medical Statistics, 9th edn. p. 260. Lancet: London.Google Scholar
Hogben, L. (1954). The assessment of remedies. Medical Press, 13 10. pp. 331–338.Google Scholar
Hogben, L. & Sim, M. (1953). The self-controlled and self-recorded clinical trial for low-grade morbidity. British Journal of Preventive Social and Medicine 7, 163–179.Google ScholarPubMed
Joyce, C. R. B. (1989). Non-specific aspects of treatment from the point of a clinical pharmacologist. In Non-specific Aspects of Treatment (ed. Shepherd, M. & Sartorius, N.), pp. 57–94. Huber: Toronto.Google Scholar
King, L. S. (1978). The Philosophy of Medicine, p. 98. University Press: Cambridge, Mass.Google Scholar
Kraepelin, E. (1892). Über die Beeinflussung einfacher psychischer Vorgänge durch einige Artzneimittel, p. 227. Fischer Verlag: Jena.Google Scholar
Lasagna, L. (1955). Placebos. Scientific American 193, 68–71.Google Scholar
Lasagna, L. (1962). Some explored and unexplored psychological variables in therapeutics. Proceedings of the Royal Society of Medicine 55, 773–776.Google Scholar
Lewis, A. (1959). The impact of psychotropic drugs on the structure, function and future of psychiatric services, (a) In the hospitals. In Neuropsychopharmacology, vol. 1, (ed. Bradley, P. B., Deniker, P. & Radouco-Thomas, C.), pp. 207–211. Elsevier: Amsterdam.Google Scholar
Mayer-Gross, W. (1959). Model psychoses: their history, relevancy and limitations. American Journal of Psychiatry 115, 673–682.Google Scholar
Medawar, P. & Medawar, J. (1985). Aristotle to Zoos, p. 244. Oxford University Press: Oxford.Google Scholar
Meehl, P. E. (1977). Specific etiology and other forms of strong influence: some quantitative meanings. Journal of Medicine and Philosophy, 2, 33–53.Google Scholar
Müller, W. E. (1987). The Benzodiazapine Receptor: Drug Acceptor only or a Physiologically Relevant Part of our Central Nervous System? Cambridge University Press: Cambridge.Google Scholar
Needham, J. (1963). Discussion, in ‘Scientific Change’, ed. Crombie, A. C., p. 656. Heinemann: London.Google Scholar
Ødegaard, Ø. (1964). Pattern of discharge from Norwegian psychiatric hospitals before and after the introduction of psychotropic drugs. American Journal Psychiatry 120, 772–778.CrossRefGoogle Scholar
Pauling, L. (1940). A theory of the structure and process of formation of antibodies. Journal of the American Chemical Society 62, 2643–2653.Google Scholar
Pepper, H. P. (1945). A note on the placebo. American Journal of Pharmacy 117, 409–412.Google Scholar
Pickering, G. W. (1949). The place of the experimental method in medicine. Proceedings of the Royal Society of Medicine XLII, 229–234.CrossRefGoogle Scholar
Prioleau, L., Murdock, M. & Brody, No. (1983). An analysis of psychotherapy versus placebo studies. Behavioural and Brain Sciences 6, 275–310.Google Scholar
Ryle, J. A. (1944). Social medicine: its meaning and its scope. Milbank Memorial Fund Quarterly 22, 58–63.Google Scholar
Sebeok, T. A. (1983). Psychotherapy and placebo. Behavioural and Brain Sciences 6, 300.Google Scholar
Shapiro, A. K. (1968). Semantics of the placebo. Psychiatric Quarterly 42, 653–696.Google Scholar
Shepherd, M., Goodman, N. & Watt, D. C. (1961). The application of hospital statistics in the evaluation of pharmacotherapy in a psychiatric population. Comprehensive Psychiatry 2, 11–19.CrossRefGoogle Scholar
Shryock, R. H. (1969). The concept of the specific in American medicine. Proceedings of the 21st International Congress of the History of Medicine, pp. 755–761. Arti Grafiche & Cossidente: Rome.Google Scholar
Temkin, O. (1963). The scientific approach to disease: specific entity and individual sickness. In Scientific Change (ed. Crombie, A. C.), pp. 629–647. Heinemann: London.Google Scholar
Temkin, O. (1972). Fernel, Joubert and Erastus on the Specificity of Cathartic Drugs. In Science, Medicine and Society in the Renaissance: Essays to Honor Walter Pagel (ed. Debus, A. G., vol. 1, pp. 61–68. Neale Watson: New York.Google Scholar
Virchow, R. (1854). Specifiker und Specifisches. Virchow's Archive 6, 3–33.Google Scholar
White, S. (1985). Medicine's humble humbug: four periods in the understanding of the placebo. Pharmacy in History 27, 1–10.Google Scholar
White, L., Thursky, B. & Schwartz, G. E. (eds.) (1985). Placebo: Theory, Research and Mechanisms. Guildford Press: New York.Google Scholar
Wickramasekera, I. (1985). A conditioned response model of the placebo effect: predictions from the model. In Placebo: Theory, Research and Mechanisms (ed. White, L., Thursky, B. and Schwartz, G. E.), pp. 255–287. Guildford Press: New York.Google Scholar
Wolf, S. (1961). Disease as a way of life: neural integration in systemic pathology. Perspectives in Biology and Medicine IV, 288–305.Google Scholar