The overall aim of the Ph.D.-project is to study contextual factors within rheumatological diseases, to determine which has the potential to either produce a placebo- or nocebo response.
When placebo phenomena are analysed, it can be difficult to separate the placebo effect from that of contextual factors, regression to the mean, and natural remission or natural history of the disease. Placebo responses are known to depend on a variety of factors; some are drug related, some patient related, but also health care provider related. Combined these factors are called contextual factors and earlier work have tried to describe contextual factors. However, much is still left to be understood concerning the nature of placebo responses within different diseases and diagnosis. While it is seen in the literature that the terms Placebo and nocebo effect (changes attributable to specific neurobiological or psychological mechanisms) and -response (health changes after the administrations of inert treatments) are used interchangeably, the thesis will focus on the placebo response at large. The Society of Interdisciplinary Placebo Studies have adopted an expert consensus noting that … maximising placebo effects and minimising nocebo effects should lead to an overall better outcome for patients. But also noting, that more research is needed to produce evidence-based recommendations for healthcare professionals in medical practice.