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Ballering AV, Plug I, van Zon SKR, Olde Hartman T, Das E, Rosmalen J. Different patterns of persistent somatic symptoms after COVID-19 reported by the Dutch media and the general population. J Psychosom Res 2024; 186:111886. [PMID: 39167967 DOI: 10.1016/j.jpsychores.2024.111886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/08/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE Post COVID-19 condition is characterized by persistent symptoms after COVID-19 with yet unknown etiology. To explore whether media-related nocebo effects potentially contribute to post COVID-19 condition, we studied in an observational cohort whether frequencies of media coverage of symptoms after COVID-19 corresponded with prevalence rates of these symptoms in participants from a general population cohort diagnosed with COVID-19. METHODS Prevalence rates and typology of symptoms after COVID-19 in the general population (N = 4231), adjusted for prevalence rates in a matched non-infected control population (n = 8462) were calculated by using data on 23 symptoms from the Lifelines COVID-19 Cohort collected between March 2020 and August 2021. Media coverage of post COVID-19 condition was assessed by coding 1266 Dutch post COVID-19-related news articles (inter-rater-κ ≥ 0.75), published during the corresponding timeframe. Herein, we assessed whether the same 23 symptoms were mentioned as being related to post COVID-19 condition. RESULTS Core post COVID-19 condition symptoms were mentioned in 390 (30.8%) articles. Five of the ten core symptoms were mentioned by 10 or fewer articles. Ageusia/anosmia was most often persistently increased in COVID-19-positive participants (7.6%), yet was mentioned in 80 (6.3%) articles. General tiredness and breathing difficulties were frequently mentioned, in 23.9% and 17.1% of the articles respectively, while these were not the most frequently increased symptoms reported by participants (4.9% and 2.4%). CONCLUSION If post COVID-19 condition was predominantly attributable to nocebo effects, its symptom profile would be expected to reflect levels of media coverage for symptoms after COVID-19. However, our findings do not support this.
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Affiliation(s)
- Aranka Vivienne Ballering
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, the Netherlands.
| | - Ilona Plug
- VU University Amsterdam, Department of Language, Literature and Communication, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands.
| | - Sander K R van Zon
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Netherlands Organisation for Applied Scientific Research, Unit Healthy Living & Work, Sylviusweg 71, 2333 BE Leiden, the Netherlands.
| | - Tim Olde Hartman
- Radboud University Medical Center, Radboud Institute of Medical Innovation, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | - Enny Das
- Centre for Language Studies, Radboud University, Erasmusplein 1, 6525 HT Nijmegen, the Netherlands.
| | - Judith Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Hanzeplein 1, P.O. Box 30.001, 9700 RB Groningen, the Netherlands.
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Asan L, Kleine-Borgmann J, Bozkurt B, Frank B, Köhrmann M, Kleinschnitz C, Bingel U. Media coverage of COVID-19 vaccination-associated cerebral venous sinus thrombosis was followed by a surge in emergency presentations due to headache - observations from a university hospital in Germany. Front Psychiatry 2024; 15:1378472. [PMID: 38846915 PMCID: PMC11153761 DOI: 10.3389/fpsyt.2024.1378472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/01/2024] [Indexed: 06/09/2024] Open
Abstract
Nocebo effects describe all negative outcomes for well-being brought about by negative health-related expectations. Media coverage of drug side effects can fuel nocebo effects and lead to increased symptom reports. This retrospective observational analysis of emergency reports at the neurological emergency room at University Hospital Essen, Germany, examines whether media communication about a cumulation of very rare cases of cerebral venous sinus thrombosis (CVST) after COVID-19 vaccination with the AstraZeneca compound (ChAdOx-1 nCoV-19) was followed by an increase in weekly presentation rates of patients with the main complaint of headache, a symptom commonly occurring as a vaccination reaction but also communicated as a warning symptom for CVST. The rate of headache presentations increased by 171.7% during the five weeks after the first announcement of CVSTs in Germany on 11 March 2021, compared to the five weeks immediately prior. Furthermore, more young women sought consultation for headache, reflecting the communicated at-risk profile for CVST. The increased rate of headache presenters contributed to a 32.1% rise in total neurological emergency cases, causing an increased strain on the emergency facility after the side effect risk was publicized. We discuss a causal role of negative side effect expectations after vaccination with AstraZeneca as a driver for this increase. While transparent communication about benefits and potential side effects is crucial for vaccination acceptance, increased vigilance toward nocebo effects in health-related media communication is needed due to its potential harm to the individual and society, especially when emergency medical resources are stretched thin.
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Affiliation(s)
- Livia Asan
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Essen, Germany
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Ma B, Park YJ, Barber K, Mydlarski PR. Nocebo effects in systemic therapies for adult plaque psoriasis: A systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1373520. [PMID: 38601115 PMCID: PMC11004429 DOI: 10.3389/fmed.2024.1373520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/26/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction The nocebo effect is defined as adverse outcomes secondary to negative patient expectations rather than the pharmacologic activity of an intervention. Nocebo effects can reduce treatment adherence and/or persistence. Therefore, nocebo effects in psoriasis need to be defined. Methods A Cochrane systematic review was updated with a search of MEDLINE, Embase, and the CENTRAL Register of Controlled Trials for phase II - IV RCTs comparing systemic therapy versus placebo for patients with moderate-to-severe plaque psoriasis. Estimates were pooled using a random effects model, and heterogeneity was evaluated using the I2 statistic. The primary outcome was the pooled proportion of any adverse event (AE) and corresponding risk difference (RD) in patients randomized to placebo versus systemic therapy. Results A total of 103 unique trials were identified enrolling 43,189 patients. The overall pooled AE rate in patients randomized to systemic therapy was 57.1% [95% CI: 54.7-59.5%] compared to 49.8% [95% CI: 47.1-52.4%] for placebo [RD 6.7% (95% CI: 4.6-8.9%), p < 0.00001, I2 = 75%]. Both biologic and non-biologic systemic therapy groups had a higher proportion of infectious AEs compared to placebo. No statistically significant RD in serious AEs or AEs leading to discontinuation was identified between systemic therapy and placebo groups. Discussion Half of patients exposed to inert placebo in clinical trials of systemic psoriasis therapies experienced AEs, which may be explained by nocebo effects. These findings have important implications when counseling patients and designing future studies.
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Affiliation(s)
- Bryan Ma
- Division of Dermatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ye-Jean Park
- Division of Dermatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kirk Barber
- Division of Dermatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - P. Régine Mydlarski
- Division of Dermatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Abstract
Adverse nocebo responses can cause harm to patients and interfere with treatment adherence and effects in both clinic practice and clinical trials. Nocebo responses refer to negative outcomes to active medical treatments in clinical trials or practice that cannot be explained by the treatment's pharmacologic effects. Negative expectancies and nocebo effects are less known than placebo responses. Nocebo effects can be triggered by verbal suggestions, prior negative experiences, observation of others experiencing negative outcomes, and other contextual and environmental factors. As research advances over the years, mechanistic knowledge is accumulating on the neurobiological mechanisms of nocebo effects. This review summarizes studies on different facets of nocebo effects and responses and discusses clinical implications, ethical considerations, and future directions.
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Affiliation(s)
- Luana Colloca
- Department of Pain and Translational Symptom Science and Placebo Beyond Opinions Center, School of Nursing, University of Maryland, Baltimore, Maryland, USA;
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MacKrill K, Witthöft M, Wessely S, Petrie KJ. Health Scares: Tracing Their Nature, Growth and Spread. CLINICAL PSYCHOLOGY IN EUROPE 2023; 5:e12209. [PMID: 38357430 PMCID: PMC10863677 DOI: 10.32872/cpe.12209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/18/2023] [Indexed: 02/16/2024] Open
Abstract
Background Health scares are highly publicised threats to health that increase public concern and protective behaviours but are later shown to be unfounded. Although health scares have become more common in recent times, they have received very little research attention. This is despite the fact that health scares often have negative outcomes for individuals and community by affecting health behaviours and causing high levels of often unnecessary anxiety. Method In this paper we undertook a review and analysis of the major types of health scares as well as the background factors associated with health scares and their spread. Results We found most health scares fell into seven main categories; environmental contaminants, food, malicious incidents, medical treatments, public health interventions, radiation from technology and exotic diseases. For most health scares there are important background factors and incident characteristics that affect how they develop. Background factors include conspiracy theories, trust in governmental agencies, anxiety, modern health worries and wariness of chemicals. Incident characteristic include being newly developed, not understood or unseen, man-made rather than natural and whether the incident is out of personal control. We also identified the aspects of traditional and social media that exacerbate the rapid spread of health scares. Conclusion More research is needed to identify the characteristics of media stories that intensify the levels of public concern. Guidelines around the media's reporting of health incidents and potential health threats may be necessary in order to reduce levels of public anxiety and the negative public health impact of health scares.
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Affiliation(s)
- Kate MacKrill
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Simon Wessely
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Keith J. Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Murdoch R, Mihov B, Horne AM, Petrie KJ, Gamble GD, Dalbeth N. Impact of Television Depictions of Gout on Perceptions of Illness: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2023; 75:2151-2157. [PMID: 37038965 DOI: 10.1002/acr.25130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/06/2023] [Accepted: 04/04/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Gout is a chronic disease that can be effectively managed with long-term urate-lowering therapy. However, it is frequently portrayed on screen as an acute disease caused by a poor diet that should be managed with lifestyle changes. This study was undertaken to investigate the impact of a fictional television depiction of gout on perceptions of the disease and its management. METHODS In a randomized controlled single-blind study, 200 members of the public watched either a 19-minute commercial television comedy episode that depicted gout as an acute disease caused by poor diet and managed with lifestyle changes, or a control episode from the same television series that did not mention gout or other diseases. Participants completed a survey regarding their perceptions of gout, its likely causes, and management strategies. RESULTS Participants randomized to watch the gout-related episode believed gout had greater consequences (mean score of 7.1 versus 6.2 on an 11-point Likert scale; P < 0.001) and were more likely to rank the most important cause as poor eating habits compared to the control group (70% versus 38%; P < 0.001). They were also less likely to believe it is caused by genetic factors or chance. Participants watching the gout-related episode believed a change in diet would be a more effective management strategy (9.0 versus 8.4; P = 0.004) and long-term medication use would be less effective (6.9 versus 7.6; P = 0.007) compared to participants in the control group. CONCLUSION Television depictions of gout can perpetuate inaccurate beliefs regarding causes of the disease and underemphasize effective medical strategies required in chronic disease management.
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MacKrill K. Impact of media coverage on side effect reports from the COVID-19 vaccine. J Psychosom Res 2023; 164:111093. [PMID: 36435094 PMCID: PMC9670676 DOI: 10.1016/j.jpsychores.2022.111093] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Past research shows that media coverage of medicine side effects can produce a nocebo response. New Zealand news media discussed myocarditis following the Pfizer COVID-19 vaccine. This study examined whether side effects mentioned in the media increased compared to control symptoms not mentioned. METHODS The study analysed 64,086 vaccine adverse reaction reports, retrieved from the medicine safety authority. Generalised linear regressions compared the side effect rate during three discrete periods of media reporting (August 2021, December 2021, April 2022) with the pre-media baseline rate. The outcomes were weekly reports of chest discomfort, monthly reports of chest, heart and breathing symptoms, and myocarditis, pericarditis, and anxiety. Control symptoms were fever, numbness, and musculoskeletal pain. Logistic regressions investigated factors associated with side effect reporting. RESULTS The reporting rate of chest discomfort was 190% greater in the five weeks after the first media item (p < .001). The monthly reporting rates of the symptoms mentioned in the media were significantly greater after the news coverage (ps ≤ 0.001). There was no effect of media on the control side effect fever (p = .06). There was an effect of media on myocarditis, pericarditis and anxiety (ps < 0.001). Anxiety, male gender, and younger age were significantly associated with side effects. CONCLUSION The results indicate that a media-induced nocebo response occurred. This is most likely due to increased expectations and awareness of COVID-19 vaccine side effects, elevated symptom experience from anxiety, and consequently greater reporting of the symptoms in line with the media coverage.
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Affiliation(s)
- Kate MacKrill
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand..
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Increasing and dampening the nocebo response following medicine-taking: A randomised controlled trial. J Psychosom Res 2021; 150:110630. [PMID: 34607238 DOI: 10.1016/j.jpsychores.2021.110630] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/24/2021] [Accepted: 09/23/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The nocebo effect is the adverse effects of treatment that cannot be attributed to a medicine. We investigated if we could increase or decrease nocebo responding following medicine taking. A nocebo explanation to reduce side effects was compared with a negative medication news item designed to increase side effects and a control condition. METHODS 108 healthy participants enrolled in a between-subjects study purportedly testing the effect of lamotrigine (actually placebo) on mood and cognition. Participants were randomised to watch either a video explaining the nocebo effect; a negative media item on lamotrigine, or control video prior to receiving the tablet. Side effects were assessed at 45-min and 48-h. RESULTS The negative media group reported significantly more side effects (M = 0.78, SD = 1.53) than the control group (M = 0.46, SD = 1.80, p = .035) at the end of session and a greater proportion of the negative media group (33%) reported at least one side effect compared to the nocebo explanation (11%) and control group (11%, p = .020). The nocebo explanation group reported significantly fewer side effects (M = 0.38, SD = 1.16) than the control group (M = 1.37, SD = 2.98, p = .038) at the 48-h follow-up. CONCLUSION Explaining the nocebo effect may be a beneficial addition to standard medicine information for reducing side effect reporting. Negative media coverage about a drug is likely to generate increased side effects. Future research should examine the benefit of nocebo explanation in patients starting new medicines.
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Gasteiger C, den Broeder AA, Stewart S, Gasteiger N, Scholz U, Dalbeth N, Petrie KJ. The mode of delivery and content of communication strategies used in mandatory and non-mandatory biosimilar transitions: a systematic review with meta-analysis. Health Psychol Rev 2021; 17:148-168. [PMID: 34409923 DOI: 10.1080/17437199.2021.1970610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Effective patient-provider communication is crucial to promote shared decision-making. However, it is unclear how to explain treatment changes to ensure patient acceptance, such as when transitioning from a bio-originator to a biosimilar. This review investigates communication strategies used to educate patients on transitioning to biosimilars and explores whether the willingness to transition and treatment persistence differs for the delivery (verbal or written) and the amount of information provided. MEDLINE, Embase, Scopus, and relevant conference databases were systematically searched. Communication strategies from 33 studies (88% observational cohort studies) published from 2012 to 2020 were synthesized and willingness to transition, persistence, and subjective adverse events explored. Patients only received information verbally in 11 studies. The remaining 22 studies also provided written information. Cost-saving was the main reason provided for the transition. Patients were most willing to transition when receiving written and verbal information (χ2 = 5.83, p = .02) or written information that only addressed a few (3-5) concerns (χ2 = 16.08, p < .001). There was no significant difference for persistence or subjective adverse events (p's > .05). Few randomized controlled trials have been conducted. Available data shows more willingness to transition when patients received written and verbal information. Initial documents should contain basic information and consultations or telephone calls used to address concerns.
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Affiliation(s)
- Chiara Gasteiger
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Sarah Stewart
- Bone & Joint Research Group, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Norina Gasteiger
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Urte Scholz
- Department of Psychology- Applied Social and Health Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Nicola Dalbeth
- Department of Rheumatology, Auckland District Health Board, Auckland, New Zealand.,Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Keith J Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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