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Psychologische und genetische Prädiktorvariablen der Noceboantwort nach der Einnahme von Ciclosporin A und Placebos

Year: 2015
Type: dissertation
Abstract: Nocebo-induced side effects play a significant role in drug discontinuation in clinical practice, thereby negatively affecting treatment efficacy as well as patient adherence and compliance. Due to the large interindividual variability in nocebo responses, the goal of this thesis was to identify nocebo predictors in order to minimize nocebo effects and increase medical treatment benefits for patients. Psychological predictors, such as beliefs about medicines and somatosensory amplifica- tion have previously been linked to nocebo responses; however, to this date there are no known biological predictors. Recently, genetic polymorphisms in the catechol-O-methyltransferase gene (COMT) Val158Met have been identified as potential biomarkers of placebo responses. Utilizing the unique model of behaviorally conditioned immunosuppressive effects, intra-individual nocebo responses of 62 healthy male subjects were analyzed after the intake of an immunosuppressive medication (CsA) and “Placebos”. Psychological, immunological and neuroendocrine parameters were analyzed and CsA- specific and general side effects were assessed before and after medication or “Placebo” intake. The three COMT genotypes were analyzed with respect to their experienced side effects. Significantly more CsA-specific as well as general side effects were reported from Val/Val carriers during medication and “Placebo” treatment compared to the other genotype groups; and they had significantly higher scores in the somatosensory amplification scale (SSAS) and the BMQ (beliefs about medicine questionnaire). Together these data demonstrate potential psychological and genetic nocebo predictor variables. They may be utilized in decreasing adverse nocebo effects within medical contexts by implementing personal treatment regimens for individuals with a heightened risk of developing nocebo responses.
Author: Wendt, Laura
Language: English
Open Access status: green
OpenAlex ID: W7024078425
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