Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment.

BACKGROUND Placebo treatments have been reported to help patients with many diseases, but the quality of the evidence supporting this finding has not been rigorously evaluated. METHODS We conducted a systematic review of clinical trials in which patients were randomly assigned to either placebo or no treatment. A placebo could be pharmacologic (e.g., a tablet), physical (e.g., a manipulation), or psychological (e.g., a conversation). RESULTS We identified 130 trials that met our inclusion criteria. After the exclusion of 16 trials without relevant data on outcomes, there were 32 with binary outcomes (involving 3795 patients, with a median of 51 patients per trial) and 82 with continuous outcomes (involving 4730 patients, with a median of 27 patients per trial). As compared with no treatment, placebo had no significant effect on binary outcomes (pooled relative risk of an unwanted outcome with placebo, 0.95; 95 percent confidence interval, 0.88 to 1.02), regardless of whether these outcomes were subjective or objective. For the trials with continuous outcomes, placebo had a beneficial effect (pooled standardized mean difference in the value for an unwanted outcome between the placebo and untreated groups, -0.28; 95 percent confidence interval, -0.38 to -0.19), but the effect decreased with increasing sample size, indicating a possible bias related to the effects of small trials. The pooled standardized mean difference was significant for the trials with subjective outcomes (-0.36; 95 percent confidence interval, -0.47 to -0.25) but not for those with objective outcomes. In 27 trials involving the treatment of pain, placebo had a beneficial effect (-0.27; 95 percent confidence interval, -0.40 to -0.15). This corresponded to a reduction in the intensity of pain of 6.5 mm on a 100-mm visual-analogue scale. CONCLUSIONS We found little evidence in general that placebos had powerful clinical effects. Although placebos had no significant effects on objective or binary outcomes, they had possible small benefits in studies with continuous subjective outcomes and for the treatment of pain. Outside the setting of clinical trials, there is no justification for the use of placebos.

[1]  David J Torgerson,et al.  Effect of regression to the mean on decision making in health care , 2003, BMJ : British Medical Journal.

[2]  K. Matthews,et al.  Status of neurosurgery for mental disorder in Scotland , 2003, British Journal of Psychiatry.

[3]  L. Hoffer.  Complementary or alternative medicine: the need for plausibility. , 2003, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[4]  R. Temple.  Implications of effects in placebo groups. , 2003, Journal of the National Cancer Institute.

[5]  I. Tannock,et al.  Placebo effects in oncology. , 2003, Journal of the National Cancer Institute.

[6]  J. Kleijnen,et al.  Informing participants of allocation to placebo at trial closure: postal survey , 2002, BMJ : British Medical Journal.

[7]  J. Earle,et al.  The aftermath of orbital radiotherapy for graves' ophthalmopathy. , 2002, Ophthalmology.

[8]  G. Man,et al.  Can continuous positive airway pressure therapy improve the general health status of patients with obstructive sleep apnea?: a clinical effectiveness study. , 2002, Chest.

[9]  R. Albin,et al.  Sham surgery controls: intracerebral grafting of fetal tissue for Parkinson’s disease and proposed criteria for use of sham surgery controls , 2002, Journal of medical ethics.

[10]  B. Levy,et al.  Longitudinal benefit of positive self-perceptions of aging on functional health. , 2002, The journals of gerontology. Series B, Psychological sciences and social sciences.

[11]  Marc Baekelandt,et al.  Dietary fecal tagging as a cleansing method before CT colonography: initial results polyp detection and patient acceptance. , 2002, Radiology.

[12]  F. Miller,et al.  Is placebo surgery unethical? , 2002, The New England journal of medicine.

[13]  K. O'malley,et al.  A controlled trial of arthroscopic surgery for osteoarthritis of the knee. , 2002, The New England journal of medicine.

[14]  G. Guyatt,et al.  Double blind, you have been voted off the island! , 2002, Evidence-based mental health.

[15]  P. Jerabek,et al.  The functional neuroanatomy of the placebo effect. , 2002, The American journal of psychiatry.

[16]  R. Sysko,et al.  Placebo response in studies of major depression: variable, substantial, and growing. , 2002, JAMA.

[17]  G. Guyatt,et al.  “Double blind, you are the weakest link — goodbye!” , 2002, ACP journal club.

[18]  Dale H Carnegie,et al.  Symptomatic reversal of peripheral neuropathy in patients with diabetes. , 2002, Journal of the American Podiatric Medical Association.

[19]  T. Furukawa.  Review: placebo is better than no treatment for subjective continuous outcomes and for treatment of pain , 2002, ACP Journal Club.

[20]  T. Brandon,et al.  The increasing power of placebos in trials of antidepressants. , 2002, Journal of the American Medical Association (JAMA).

[21]  A. Leuchter,et al.  Changes in brain function of depressed subjects during treatment with placebo. , 2002, The American journal of psychiatry.

[22]  M. Beldoch.  Is the placebo powerless? , 2001, New England Journal of Medicine.

[23]  E. Emanuel,et al.  The ethics of placebo-controlled trials--a middle ground. , 2001, The New England journal of medicine.

[24]  M. Markman.  Interactions between academic oncology and alternative/complementary/integrative medicine: complex but necessary. , 2001, Journal of Clinical Oncology.

[25]  A. Grollman.  Need for Scholarly, Objective Inquiry into Alternative Therapies , 2001 .

[26]  J. Bailar.  The powerful placebo and the Wizard of Oz. , 2001, The New England journal of medicine.

[27]  P. Gøtzsche,et al.  Why we need a broad perspective on meta-analysis , 2000, BMJ : British Medical Journal.

[28]  T. Kaptchuk,et al.  Do medical devices have enhanced placebo effects? , 2000, Journal of clinical epidemiology.

[29]  J. Tijssen,et al.  Placebo effect in the acute treatment of migraine: subcutaneous placebos are better than oral placebos , 2000, Journal of Neurology.

[30]  J. Tijssen,et al.  Placebo effect in the treatment of duodenal ulcer. , 1999, British journal of clinical pharmacology.

[31]  N. Tarrier,et al.  Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia , 1998, BMJ.

[32]  T. Alraek,et al.  Kan akupunktur forebygge blærekatarr hos kvinner , 1998 .

[33]  T. Alraek,et al.  [Can acupuncture prevent cystitis in women?]. , 1998, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.

[34]  R. Holman,et al.  The Fasting Hyperglycaemia Study: III. Randomized controlled trial of sulfonylurea therapy in subjects with increased but not diabetic fasting plasma glucose. , 1997, Metabolism: clinical and experimental.

[35]  H. Kiene,et al.  The powerful placebo effect: fact or fiction? , 1997, Journal of clinical epidemiology.

[36]  Wayne B Jonas,et al.  Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials , 1997, The Lancet.

[37]  G. Smith,et al.  Bias in meta-analysis detected by a simple, graphical test , 1997, BMJ.

[38]  B. Goodenough,et al.  An investigation of the placebo effect and age-related factors in the report of needle pain from venipuncture in children , 1997, Pain.

[39]  Jesse A Berlin,et al.  Does blinding of readers affect the results of meta-analyses? , 1997, The Lancet.

[40]  T. Bell,et al.  A randomized controlled trial of transurethral microwave thermotherapy. , 1997, British journal of urology.

[41]  F. Benedetti,et al.  Control of postoperative pain by transcutaneous electrical nerve stimulation after thoracic operations. , 1997, The Annals of thoracic surgery.

[42]  L. Hedges,et al.  Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. , 1997, Lancet.

[43]  J. Kleijnen,et al.  Effect of colour of drugs: systematic review of perceived effect of drugs and of their effectiveness , 1996, BMJ.

[44]  R. Grissom,et al.  The magical number .7 +/- .2: meta-meta-analysis of the probability of superior outcome in comparisons involving therapy, placebo, and control. , 1996, Journal of consulting and clinical psychology.

[45]  A. Kim.  Oral transmucosal fentanyl citrate for premedication in adults , 1996 .

[46]  P. Richardson,et al.  A placebo controlled double blind trial to evaluate the effectiveness of pulsed short wave therapy for osteoarthritic hip and knee pain , 1996, PAIN.

[47]  M. I. Sachs.  A DOSE-RESPONSE STUDY OF THE EFFICACY AND SAFETY OF IPRATROPIUM BROMIDE NASAL SPRAY IN THE TREATMENT OF THE COMMON COLD , 1996, Pediatrics.

[48]  F. Hayden,et al.  Effectiveness and Safety of Intranasal Ipratropium Bromide in Common Colds , 1996, Annals of Internal Medicine.

[49]  B. Scherstén,et al.  Changes in cardiovascular risk factors by combined pharmacological and nonpharmacological strategies: the main results of the CELL Study , 1996, Journal of internal medicine.

[50]  J. Vlaeyen,et al.  Cognitive-educational treatment of fibromyalgia: a randomized clinical trial. I. Clinical effects. , 1996, The Journal of rheumatology.

[51]  M. Rowbotham,et al.  Lidocaine patch: double-blind controlled study of a new treatment method for post-herpetic neuralgia , 1996, Pain.

[52]  B. O'brien,et al.  Efficacy of P6 acupressure in the treatment of nausea and vomiting during pregnancy. , 1996, American journal of obstetrics and gynecology.

[53]  R. Friedman,et al.  The effects of relaxation response training on menopausal symptoms. , 1996, Journal of psychosomatic obstetrics and gynaecology.

[54]  A. Hrõbjartsson.  The uncontrollable placebo effect , 1996, European Journal of Clinical Pharmacology.

[55]  J. Hewett,et al.  Effects of stress management on clinical outcomes in rheumatoid arthritis. , 1995, Arthritis and rheumatism.

[56]  F. Benedetti,et al.  Potentiation of placebo analgesia by proglumide , 1995, The Lancet.

[57]  P. Coyne,et al.  Transcutaneous electrical nerve stimulator for procedural pain associated with intravenous needlesticks. , 1995, Journal of intravenous nursing : the official publication of the Intravenous Nurses Society.

[58]  E. Ernst,et al.  Concept of true and perceived placebo effects , 1995, BMJ.

[59]  A. Adriaanse,et al.  Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci. , 1995, European journal of obstetrics, gynecology, and reproductive biology.

[60]  C. Liossi,et al.  Hypnotherapy for control of anticipatory nausea and vomiting in children with cancer: Preliminary findings , 1995 .

[61]  J A Rodgers,et al.  A Dyadic Remediation Program for Care Recipients with Dementia , 1995, Nursing research.

[62]  R. J. Hayes,et al.  Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. , 1995, JAMA.

[63]  J. Kleijnen,et al.  Placebo effect in double-blind clinical trials: a review of interactions with medications , 1994, The Lancet.

[64]  R. Novick,et al.  Effect of TENS on pain, medications, and pulmonary function following coronary artery bypass graft surgery. , 1994, Chest.

[65]  A. Herxheimer,et al.  Harnessing placebo effects in health care , 1994, The Lancet.

[66]  P. Gøtzsche.  Is there logic in the placebo? , 1994, The Lancet.

[67]  V. Oh.  The placebo effect: can we use it better? , 1994, BMJ.

[68]  R A Deyo,et al.  The importance of placebo effects in pain treatment and research. , 1994, JAMA.

[69]  O. Chassany,et al.  A randomised clinical trial of the effect of informed consent on the analgesic activity of placebo and naproxen in cancer pain. , 1994, Clinical trials and meta-analysis.

[70]  B. Cmolik,et al.  Iron supplementation for acute blood loss anemia after coronary artery bypass surgery: a randomized, placebo-controlled study. , 1992, Heart & lung : the journal of critical care.

[71]  A. Pachì,et al.  Pain evaluation during carbon dioxide laser vaporization for cervical intraepithelial neoplasia: a randomized trial. , 1994, Clinical and experimental obstetrics & gynecology.

[72]  R. Bunch.  A randomized, placebo-controlled trial of exercise therapy in patients with acute low back pain. , 1994, Spine.

[73]  P. Monsalve,et al.  A behavioral treatment program as a therapy in the control of primary hypertension. , 1994, Acta cientifica venezolana.

[74]  D. Markland,et al.  Anxiety, relaxation and anaesthesia for day-case surgery. , 1994, The British journal of clinical psychology.

[75]  R. Rowlands,et al.  Efficacy of maintenance use of anticholinergic agents , 1993, Acta psychiatrica Scandinavica.

[76]  M. Scheinin,et al.  Monoamine metabolite and catecholamine measurements in cerebrospinal fluid in determining the quality of the pre-operative night's sleep. , 1993, European Journal of Anaesthesiology.

[77]  R. Walton,et al.  Prophylactic penicillin: effect on posttreatment symptoms following root canal treatment of asymptomatic periapical pathosis. , 1993, Journal of endodontics.

[78]  C. McMillan.  Transcutaneous Electrical Stimulation of Neiguan Anti-emetic Acupuncture Point in Controlling Sickness following Opioid Analgesia in Major Orthopaedic Surgery , 1993 .

[79]  H. Sprott,et al.  Wirksamkeit der Akupunktur bei Patienten mit generalisierter Tendomyopathie (Fibromyalgie) , 1993 .

[80]  A. Morton,et al.  Efficacy of laser-acupuncture in the prevention of exercise-induced asthma. , 1993, Annals of allergy.

[81]  S. Bachrach,et al.  Efficacy of intranasal midazolam in facilitating suturing of lacerations in preschool children in the emergency department. , 1993, Pediatrics.

[82]  J. Lander,et al.  TENS for children's procedural pain , 1993, Pain.

[83]  C. Hong,et al.  Immediate Effects of Various Physical Medicine Modalities on Pain Threshold of an Active Myofascial Trigger Point , 1993 .

[84]  M. Hovell,et al.  The power of nonspecific effects in healing: Implications for psychosocial and biological treatments , 1993 .

[85]  W. Pelham,et al.  Methylphenidate and attributions in boys with attention-deficit hyperactivity disorder. , 1992, Journal of consulting and clinical psychology.

[86]  D. Kupfer,et al.  Five-year outcome for maintenance therapies in recurrent depression. , 1990, Archives of general psychiatry.

[87]  J. Demouzon,et al.  [Protocol of cervical maturation by acupuncture]. , 1992, Journal de gynecologie, obstetrique et biologie de la reproduction.

[88]  M. Sela,et al.  Local application of sustained-release delivery system of chlorhexidine in Down's syndrome population. , 1991, Clinical preventive dentistry.

[89]  D. McLachlan,et al.  Intramuscular desferrioxamine in patients with Alzheimer's disease , 1991, The Lancet.

[90]  J. Stewart,et al.  The effect of a cognitive behavioral intervention on oral hygiene. , 1991, Journal of clinical periodontology.

[91]  M. L. Tremeau,et al.  Protocole de maturation cervicale par acupuncture , 1991 .

[92]  N. Holtzman,et al.  Effectiveness of an antihistamine-decongestant combination for young children with the common cold: a randomized, controlled clinical trial. , 1991, The Journal of pediatrics.

[93]  M. Antivalle,et al.  Placebo effect and adaptation to noninvasive monitoring of BP. , 1990, Journal of human hypertension.

[94]  D. Klein,et al.  Effects of pill-giving on maintenance of placebo response in patients with chronic mild depression. , 1990, The American journal of psychiatry.

[95]  R. Tepe,et al.  Chiropractic adjustive manipulation on subjects with acute low back pain: visual analog pain scores and plasma beta-endorphin levels. , 1990, Journal of manipulative and physiological therapeutics.

[96]  B. Rybarczyk,et al.  Reminiscence interviews as stress management interventions for older patients undergoing surgery. , 1990, The gerontologist.

[97]  S. Fortmann,et al.  Evaluation of a treatment approach combining nicotine gum with self-guided behavioral treatments for smoking relapse prevention. , 1990, Journal of consulting and clinical psychology.

[98]  P. Damm,et al.  Prevention of Breast Pain and Milk Secretion with Bromocriptine After Second‐Trimester Abortion , 1990, Acta Obstetricia et Gynecologica Scandinavica.

[99]  Peter C. G∅tzsche.  Sensitivity of effect variables in rheumatoid arthritis: A meta-analysis of 130 placebo controlled NSAID trials controlled NSAID trials , 1990 .

[100]  P. Gøtzsche.  Sensitivity of effect variables in rheumatoid arthritis: a meta-analysis of 130 placebo controlled NSAID trials. , 1990, Journal of clinical epidemiology.

[101]  D J Kupfer,et al.  Three-year outcomes for maintenance therapies in recurrent depression. , 1990, Archives of general psychiatry.

[102]  N. Lava,et al.  Treatment of carpal tunnel syndrome with vitamin B6: a double-blind study. , 1989, Southern medical journal.

[103]  J. Lander,et al.  Use of Transcutaneous Electrical Nerve Stimulation For Postoperative Pain , 1989, Nursing research.

[104]  C. Espie,et al.  A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia. , 1989, Behaviour research and therapy.

[105]  D. Lamping,et al.  Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial. , 1988, Journal of manipulative and physiological therapeutics.

[106]  M. Mussell,et al.  Trachea-noise biofeedback in asthma: A comparison of the effect of trachea-noise biofeedback, a bronchodilator, and no treatment on the rate of recovery from exercise- and eucapnic hyperventilation-induced asthma , 1988, Biofeedback and self-regulation.

[107]  N. Hansen,et al.  Comparison of terbutaline, isotonic saline, ambient air and non-treatment in patients with reversible chronic airway obstruction. , 1988, The European respiratory journal.

[108]  W. Harvey,et al.  Reduction of postoperative pain and swelling by ultrasound treatment: a placebo effect , 1988, Pain.

[109]  G. Clum,et al.  Psychosocial treatment for recurrent genital herpes. , 1988, Journal of consulting and clinical psychology.

[110]  J M Williams,et al.  Use of single session hypnosis for smoking cessation. , 1988, Addictive behaviors.

[111]  K. Thomas.  General practice consultations: is there any point in being positive? , 1987, British medical journal.

[112]  J. Helms.  Acupuncture for the management of primary dysmenorrhea , 1987, Obstetrics and gynecology.

[113]  I. Conn.  Transcutaneous electrical nerve stimulation following appendicectomy: the placebo effect. , 1986, Annals of the Royal College of Surgeons of England.

[114]  D. Dush.  The Placebo in Psychosocial Outcome Evaluations , 1986 .

[115]  J. Dundee,et al.  Traditional Chinese acupuncture: a potentially useful antiemetic? , 1986, British medical journal.

[116]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[117]  J. Kanis,et al.  Does informed consent influence therapeutic outcome? A clinical trial of the hypnotic activity of placebo in patients admitted to hospital. , 1986, British medical journal.

[118]  L. Lasagna.  The placebo effect. , 1986, The Journal of allergy and clinical immunology.

[119]  J. C. Daly,et al.  Transcutaneous electrical nerve stimulation following appendicectomy: the placebo effect. , 1986, Annals of the Royal College of Surgeons of England.

[120]  J Bruni,et al.  Cognitive‐Behavior Therapy with Adult Patients with Epilepsy: A Controlled Outcome Study , 1986, Epilepsia.

[121]  W. Harvey,et al.  Anti-inflammatory effects of ultrasound therapy: evidence for a major placebo effect. , 1986, British journal of rheumatology.

[122]  F. Rist,et al.  Placebo-Injektionen und Alkoholkontrollen in der stationären Behandlung alkoholkranker Frauen ― eine experimentelle Untersuchung zweier Behandlungsmerkmale , 1986 .

[123]  R. Stanley,et al.  Treatment effectiveness of hypnosis and behaviour therapy in smoking cessation: a methodological refinement. , 1986, Addictive behaviors.

[124]  A. Lamazza,et al.  Effects of pinaverium bromide in the premedication of endoscopic retrograde cholangio-pancreatography and on motor activity of the sphincter of Oddi. , 1986, Current Medical Research and Opinion.

[125]  L. Hedges,et al.  Statistical Methods for Meta-Analysis , 1987 .

[126]  S. Spence,et al.  Rapid versus Gradual Scheduling of Therapeutic Contact in a Family Based Behavioural Weight Control Programme for Children , 1985, Behavioural and Cognitive Psychotherapy.

[127]  W. Classen,et al.  Use of Placebos in Medical Practice , 1985 .

[128]  Ingram Olkin,et al.  Estimation of a Single Effect Size: Parametric and Nonparametric Methods , 1985 .

[129]  P. Bramston,et al.  Behavioural versus cognitive social-skills training with intellectually-handicapped adults. , 1985, Behaviour research and therapy.

[130]  R. Patterson,et al.  Asthma as a variable in a study of immunotherapy for allergic rhinitis. , 1984, Journal of Allergy and Clinical Immunology.

[131]  J. Levine,et al.  Influence of the method of drug administration on analgesic response , 1984, Nature.

[132]  R. Dubner,et al.  Placebo and naloxone can alter post-surgical pain by separate mechanisms , 1983, Nature.

[133]  I. Berg,et al.  A controlled trial of 'Senokot' in faecal soiling treated by behavioural methods. , 1983, Journal of child psychology and psychiatry, and allied disciplines.

[134]  C. Banner,et al.  Examination of the effectiveness of various treatment techniques for reducing tension. , 1983, The British journal of clinical psychology.

[135]  P. Netter,et al.  Influence of sensory suggestibility on treatment outcome in headache patients. , 1983, Neuropsychobiology.

[136]  D. Williamson,et al.  The long-term effects of spouse involvement upon weight loss and maintenance , 1982 .

[137]  D. Shapiro,et al.  Meta-analysis of comparative therapy outcome studies: a replication and refinement. , 1982, Psychological bulletin.

[138]  B. Lomanto,et al.  The hypotensive effect of a single daily dose of labetalol: a preliminary study. , 1982, International journal of clinical pharmacology, therapy and toxicology.

[139]  A. Reading.  The effects of psychological preparation on pain and recovery after minor gynaecological surgery: a preliminary report. , 1982, Journal of clinical psychology.

[140]  R. Kaplan,et al.  Training children to cope with dental treatment. , 1982, Journal of pediatric psychology.

[141]  R. Patterson,et al.  Skin temperature biofeedback for Raynaud's disease: A double-blind study , 1982, Biofeedback and self-regulation.

[142]  E. Poser,et al.  Acute pain in a clinical setting: effects of cognitive-behavioural skills training. , 1982, Behaviour research and therapy.

[143]  D. Bowman,et al.  Physiologic Observations in a Controlled Clinical Trial of the Antiemetic Effectiveness of 5, 10, and 15 mg of Δ9‐Tetrahydrocannabinol in Cancer Chemotherapy. Ophthalmologic Implications , 1981, Journal of clinical pharmacology.

[144]  P. Roughan,et al.  Do pelvic floor exercises really improve orgasmic potential? , 1981, Journal of sex & marital therapy.

[145]  S. Heinzl,et al.  Preoperative administration of prostaglandin to avoid dilatation-induced damage in first-trimester pregnancy terminations. , 1981, Gynecologic and obstetric investigation.

[146]  J. Tuomilehto,et al.  Effect of Guar Gum on Body Weight and Serum Lipids in Hypercholesterolemic Females , 2009 .

[147]  A. Wilson,et al.  Disulfiram implantation: a trial using placebo implants and two types of controls. , 1980, Journal of studies on alcohol.

[148]  J. Block.  Effects of rational emotive therapy on overweight adults. , 1980 .

[149]  Gene V. Glass,et al.  The benefits of psychotherapy , 1980 .

[150]  C. Elliott,et al.  Suppression and substitution in the treatment of nailbiting. , 1980, Behaviour research and therapy.

[151]  L. Ascher,et al.  Controlled comparison of progressive relaxation, stimulus control, and paradoxical intention therapies for insomnia. , 1979, Journal of consulting and clinical psychology.

[152]  P. Kendall,et al.  Cognitive-behavioral and patient education interventions in cardiac catheterization procedures: the Palo Alto Medical Psychology Project. , 1979, Journal of consulting and clinical psychology.

[153]  L. Ascher,et al.  Paradoxical intention and insomnia: an experimental investigation. , 1979, Behaviour research and therapy.

[154]  C. Elliott,et al.  A multiple-component treatment approach to smoking reduction. , 1978, Journal of consulting and clinical psychology.

[155]  D. S. Holmes,et al.  Effects of multiple sessions of true and placebo heart rate biofeedback training on the heart rates and anxiety levels of anxious patients during and following treatment. , 1978, Psychophysiology.

[156]  N. Jacobson,et al.  Specific and nonspecific factors in the effectiveness of a behavioral approach to the treatment of marital discord. , 1978, Journal of consulting and clinical psychology.

[157]  K. Gaarder,et al.  Treatment of Hypertension with Biofeedback and Relaxation Techniques , 1978, Psychosomatic medicine.

[158]  J. Lick,et al.  Relaxation training and attention placebo in the treatment of severe insomnia. , 1977, Journal of consulting and clinical psychology.

[159]  L. Rehm,et al.  A self-control behavior therapy program for depression. , 1977, Journal of consulting and clinical psychology.

[160]  D. Nandi,et al.  A Clinical Evaluation of Depressives Found in a Rural Survey in India , 1976, British Journal of Psychiatry.

[161]  K. Holmes,et al.  Genital herpetic infection in men and women: clinical course and effect of topical application of adenine arabinoside. , 1976, The Journal of infectious diseases.

[162]  S. Hall,et al.  Use of programmed instruction in teaching self-management skills to overweight adults * , 1976 .

[163]  R. Glasgow,et al.  A controlled study to assess the clinical efficacy of totally self-administered systematic desensitization. , 1976, Journal of consulting and clinical psychology.

[164]  J. Lick.  Expectancy, false galvanic skin response feedback, and systematic desensitization in the modification of phobic behavior. , 1975, Journal of consulting and clinical psychology.

[165]  R. Harrison,et al.  DOXYCYCLINE TREATMENT AND HUMAN INFERTILITY , 1975, The Lancet.

[166]  D. W. Doty.  Role playing and incentives in the modification of the social interaction of chronic psychiatric patients. , 1975, Journal of consulting and clinical psychology.

[167]  R. G. Hall,et al.  Permance of two self-managed treatments of overweight in university and community populations. , 1974, Journal of consulting and clinical psychology.

[168]  R. Russell,et al.  A comparison of covert sensitization and “nonspecific” treatment in the modification of smoking behavior , 1974 .

[169]  R. Bootzin,et al.  A comparison of progressive relaxation and autogenic training as treatments for insomnia. , 1974, Journal of abnormal psychology.

[170]  G. Klerman,et al.  Treatment of depression by drugs and psychotherapy. , 1974, The American journal of psychiatry.

[171]  S. Godfrey,et al.  Demonstration by placebo response in asthma by means of exercise testing. , 1973, Journal of psychosomatic research.

[172]  P. Knapp,et al.  Interaction of Personality and Treatment Conditions Associated with Success in a Smoking Control Program , 1971, Psychosomatic medicine.

[173]  A. H. Weingaertner.  Self-administered aversive stimulation with hallucinating hospitalized schizophrenics. , 1971, Journal of consulting and clinical psychology.

[174]  Claudia Winograd.  Massachusetts medical society. , 1970, The New England journal of medicine.

[175]  S. Blackman,et al.  THE EFFECT OF IMIPRAMINE ON ENURESIS. , 1964, American Journal of Psychiatry.

[176]  E. Forgy,et al.  CONTROLLED STUDY OF PSYCHIATRIC OUTPATIENT TREATMENT. , 1964, Archives of general psychiatry.

[177]  R. Hoy,et al.  Withdrawal of Perphenazine in Chronic Schizophrenia , 1963, British Journal of Psychiatry.

[178]  W. Holland,et al.  A double-blind study of the treatment of hypertension. , 1961, JAMA.

[179]  M. Lorr,et al.  Meprobamate and chlorpromazine in psychotherapy. Some effects on anxiety and hostility of outpatients. , 1961, Archives of general psychiatry.

[180]  V. A. Stehman,et al.  Treatment of chronic schizophrenia with promazine hydrochloride. , 1957, A.M.A. archives of neurology and psychiatry.

[181]  E. Traut,et al.  Placebos in the Treatment of Rheumatoid Arthritis and other Rheumatic Conditions * , 1957, Annals of the rheumatic diseases.

[182]  D. Pearl,et al.  The effects of reserpine on schizophrenic patients. , 1956, A.M.A. archives of neurology and psychiatry.

[183]  H. Beecher,et al.  The powerful placebo. , 1955, Journal of the American Medical Association.

[184]  R. Lucero,et al.  A controlled study of reserpine on chronically disturbed patients. , 1955, A.M.A. archives of neurology and psychiatry.

[185]  D B TYLER,et al.  The influence of a placebo, body position and medication on motion sickness. , 1946, The American journal of physiology.