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A systematic review of sex differences in the placebo and the nocebo effect

Authors Vambheim SM, Flaten MA

Received 15 February 2017

Accepted for publication 23 June 2017

Published 31 July 2017 Volume 2017:10 Pages 1831—1839

DOI https://doi.org/10.2147/JPR.S134745

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr E. Alfonso Romero-Sandoval

Sara M Vambheim,1 Magne Arve Flaten2

1Department of Psychology, UiT, The Arctic University of Norway, Tromsø, 2Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

Objectives: The present review investigated whether there are systematic sex differences in the placebo and the nocebo effect.
Methods: A literature search was conducted in multiple electronic databases. Studies were included if the study compared a group or condition where a placebo was administered to a natural history group or similar cohort.
Results: Eighteen studies were identified – 12 on placebo effects and 6 on nocebo effects. Chi-square tests revealed that 1) males responded more strongly to placebo treatment, and females responded more strongly to nocebo treatment, and 2) males responded with larger placebo effects induced by verbal information, and females responded with larger nocebo effects induced by conditioning procedures.
Conclusion: This review indicates that there are sex differences in the placebo and nocebo effects, probably caused by sex differences in stress, anxiety, and the endogenous opioid system.

Keywords: placebo response, nocebo response, placebo analgesia, nocebo hyperalgesia, sex differences

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