Paradoxical Influence of a Therapeutic Side-Effect Interpretation

Abstract

THE CLINICAL literature is replete with references to the importance of nonpharmacological factors which may influence the response of patients to pharmacotherapy. An excellent review of these "nonspecific" factors is provided in two recent articles by Honigfeld.^1,2 In the main, however, there have been relatively few studies^3-7 which have experimentally manipulated nonpharmacological variables thought to affect therapeutic outcome. Since a number of studies have suggested that the psychological "meaning" of side-effects to the patient may reliably influence his clinical course, the present research has focused on evaluating the impact of two different side-effect interpretations on the clinical response of anxious neurotic outpatients. In this connection investigations by Kast,^8,9 by Kast and Loesch,^10,11 and by Rickels et al,¹² are particularly relevant. In studies with patients characterized by an anxiety and gas-trointestinal somatization,¹¹ hypertropic arthritis,⁹ and functional digestive disorders without organic pathology;¹⁰ Kast and Loesch used atropine sulfate (0.6 mg, t.i.d.)