NIL NOCERE? THE NOCEBO PHENOMENON (Nil nocere? A nocebo-jelenseg)

The aim of the authors' review was a comprehensive summary of the nocebo-phenomenon and a brief comparison of three phenomena (nocebo, symptom reports of healthy persons and medically unexplained symptoms) that are usually considered as distinct. According to their approach, these phenomena are so closely related in terms of triggering and maintaining mechanisms that they suggest to classify them together in an integrated conception (non-specific health problems). To confirm their hypothesis, the potential psychophysiological mechanisms (different types of expectations; classical conditioning; social learning; stress, anxiety, depression; somatisation; contents of pills; symptoms of physical illnesses) and the motivational background (need of control and misattribution; measuring of the effectiveness of drugs; resistance to therapy; guilt and self; punishment phenomena; secondary gains; conscious simulation) of these phenomena as well as the related dispositional personality factors (female gender; neuroticism; increased monitoring of bodily processes) are discussed. After comparing the nocebo with the placebo, the authors are against the widespread view that treats them as crowd mirror images of each other. Based on the literature, the possible interventions for attenuating the nocebo-effect are summarised and discussed as well.