The Nocebo Effect: Do No Harm

ABSTRACT: The nocebo effect creates negative expectations about symptoms and can have  devastating influence on patient recovery. Just as the placebo effect works by making patients  believe they will get better, the nocebo effect can serve to make patients worse. Two case  histories are presented in which patients were assigned diagnoses without objective physical  findings. This resulted in poor outcomes. Physicians should avoid assigning a diagnosis  without objective physical evidence and thus avoid creating the nocebo effect in patients.