Abstract
Psychological distress is prevalent in students and can predispose to psychiatric disorders. Recent findings indicate that distress might be linked to impaired cognitive performance in students. Experimental findings in healthy participants suggest that placebo interventions can improve cognition. However, whether non-deceptive (i.e., open-label, OLP) placebos can enhance cognitive function and emotional well-being is unclear. Using a randomized-controlled design we demonstrate a positive impact of OLP on subjective well-being (i.e., stress, fatigue, and confusion) after a 21-day OLP application in healthy students during midterm exams. OLP did not improve test performance, but, within the OLP group, test performance was positively correlated with measures of general belief in the benefit of medication. These results show that OLP can counteract negative effects of acute stress on psychological well-being and might improve cognitive performance if supported by positive treatment expectations. Additionally, our findings in healthy volunteers warrant further investigation in exploring the potential of OLP in reducing stress-related psychological effects in patients. The trial was preregistered at the German Clinical Trials Register on December 20, 2017 (DRKS00013557).
Highlights
Psychological distress is prevalent in students and can predispose to psychiatric disorders
While additional research is needed to identify personal and program strategies to promote well-being and prevent cognitive impairment in acutely stressed students[6], there is, cumulating evidence suggesting that positive expectations can have beneficial effects on cognitive performance and emotional well-being in healthy volunteers
Schaefer et al.[27] found OLP-associated improvements of test anxiety and self-management abilities in a trial enrolling N = 58 students facing an university exam. In this randomized controlled trial, we investigate the impact of a 3-week open-label placebo treatment on cognitive performance and indicators of subjective well-being including stress, mood, somatization, and depression in healthy medical students before and immediately prior to their midterm medical exams
Summary
Psychological distress is prevalent in students and can predispose to psychiatric disorders. OLP did not improve test performance, but, within the OLP group, test performance was positively correlated with measures of general belief in the benefit of medication These results show that OLP can counteract negative effects of acute stress on psychological well-being and might improve cognitive performance if supported by positive treatment expectations. It has even been suggested that in the medical student population, psychological distress involving negative mood, anxiety, and stress may predispose to severe psychiatric disorders including substance abuse, major depression, and even s uicide[6]. The positive expectation group self-selected the training session responding to an advertisement that suggested cognitive improvement. Students in the positive expectation group showed improvements that equate to a 5- to 10-point increase on a standard IQ test after the single session, pointing to the impact of expectation on cognitive performance. Is in line with an experimental study by Sinke et al.[14] reporting positive and negative effects of experimentally modified expectations linked to phasic pain stimuli on short-term memory
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