Nocebo Effects: Neurobiological Mechanisms and Strategies for Prevention and Optimizing Treatment

Abstract Psychosocial and contextual factors, such as patient–physician relationship, prior treatment experience, and treatment expectation, can either improve or compromise treatment efficacy. These phenomena are commonly specified as placebo and nocebo effects. As placebo and nocebo effects can influence symptom development, adverse event rate, and treatment efficacy, it is crucial to be aware of these effects and to develop strategies for prevention to optimize treatment outcomes. While experimental studies have made substantial progress in elucidating the psychosocial and neurobiological mechanisms underlying placebo effects, the detailed mechanisms of nocebo effects remain largely unexplored. A better understanding of these mechanisms promises to facilitate the development of easy-to-use strategies in clinical care to improve overall treatment outcomes and patient satisfaction.