Intended for healthcare professionals

Research

Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39524.439618.25 (Published 01 May 2008) Cite this as: BMJ 2008;336:999

Basic skills of CBT

Kaptchuk et al. found that the most robust component of what they consider as a placebo effect is the patient-physician relationship. (1) Although this ‘augmented patient-physician relationship’ as applied in this study presupposes some basic skills of cognitive behavioural therapy (CBT). Questions like ‘how irritable bowel syndrome is related to relationships and lifestyle’ , ‘how the patient understood the "cause" and "meaning" of his or her condition’, as well as ‘ active listening’, ‘empathy’ or ‘communication of confidence and positive expectation’ as response to patients anxiety, negative perceptions of symptoms or catastrophically way of thinking are basic techniques and primary steps of CBT.

This study proves that these basic interventions, feasible in physicians daily consultations, can be effective for IBS and most probably for other functional somatic symptoms and syndromes. Training of physicians in applying these ICE (questioning ideas, concerns and expectations of the patient) techniques in their communication with patients can be very useful.

Because of the continuity in his relationship with the patient and the holistic approach the GP has strong opportunities for a positive patient- practitioner relationship. Therefore it would be useful that this kind of research would be done in family practice.

1. Kaptchuk TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE, et al. Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. BMJ 2008 Apr 3.

Competing interests: None declared

Competing interests: No competing interests

16 April 2008
Dirk Van Duppen
GP
Grouppractice doctors for the peopele. B-2100 Antwerp