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April 1965

Nonblind Placebo TrialAn Exploration of Neurotic Patients' Responses to Placebo When Its Inert Content Is Disclosed

Arch Gen Psychiatry. 1965;12(4):336-345. doi:10.1001/archpsyc.1965.01720340008002

Introduction  THE PLACEBO effect, that is, the effect obtained when a presumably inert substance is given to normal or diseased individuals, has been the object of many studies in the last decade. A considerable amount of attention has been paid to the psychological factors underlying this effect, and many workers in the field would subscribe to what Gliedman et al5 write: "The so-called placebo effect should be looked upon as an epiphenomenon of complicated psychological processes, which are far more important than the disarmingly simple means utilized for its realization."What is the nature of these processes? Kurland13 states that ". . . the placebo reaction is generally accepted to be a manifestation of suggestion . . ."; in this framework, one common assumption is that the patient should believe he is taking an active drug.22 Throughout the vast literature on the placebo effect there is a

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