The placebo effect and psychogenic illnesses

In the above video, Karen Rommelfanger talks about the emerging field of neuroethics, and why neuroscience and technology are affecting both health-care policy and the legal system.  

Karen Rommelfanger, director of the Neuroethics Program at the Emory Center for Ethics, wrote about the placebo effect and psychogenic movement disorders as a guest blogger for Nature.com’s Soapbox Science. Below is an excerpt:

“’It’s not all in my head.’

“This is the sentiment resonating among the 18 teenage girls in Le Roy, New York, who had sudden onset of mysterious symptoms of intrusive and involuntary tics and body movements. …

“Ultimately, the girls were diagnosed with Conversion disorder or mass psychogenic illness, conditions wherein psychological stressors versus ‘organic’ pathology are thought to be literally converted to physical manifestations of symptoms (some more dramatic than others, ranging from paralysis and tics, to blindness and seizure-like movements). …

“Conversion disorder and psychogenic movement disorders (terminology which is often used interchangeably amongst physicians) are paradigmatic of 'medically unexplained illnesses,' estimated to cost the U.S. healthcare system upwards of $100 billion annually.

“However, many of the girls from Le Roy seemed to prefer the diagnosis advanced by pediatric neurologist Dr. Rosario Trifiletti, who suggested the patients were afflicted with PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus). …

“In re-considering the diagnosis of PANDAS, Dr. Rosario admitted that it would be hard to tell whether some of his patients’ recovery was from the antibiotics he prescribed or a belief in getting better – the ‘placebo effect.’ In the case of the girls from Le Roy, perhaps receiving ‘real medicine’ like antibiotics provided relief because it was consistent with the belief that they had a ‘real’ illness like PANDAS.”

Read the whole article at Soapbox Science.

Related:
The ethics surrounding placebo effects