{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T17:04:59Z","timestamp":1765904699678,"version":"3.48.0"},"reference-count":32,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"abstract":"<jats:p>Introduction: Verbal instructions modulate the expectation concerning a given drug. Knowing that the prescribing clinician is positive and enthusiastic toward the prescribed treatment may lead to positive expectations. We tested whether administering strongly positive verbal instructions together with a pharmacological prescription might trigger a placebo effect in migraine patients. Methods: Outpatients (n = 102) were randomly assigned to: (a) an experimental condition: the pharmacological prescription was coupled to strongly positive verbal instructions; (b) a control condition: the prescription was coupled to positive verbal instructions. Subjects were assessed before the prescription (T0), 7 days (T1), 15 days (T2), 1 month (T3), 2 months (T4), and 3 months after it (T5). At each assessment point, Headache Impact Test (HIT-6) and two Numeric Rating Scales (NRSs) were proposed. Kellner\u2019s scale of change was administered at T1\u2013T5. Results: Patients who received strongly positive instructions had no HIT decrease (p = 0.177; \u03b72 = 0.034). Patients who received positive instructions had HIT decrease (p = 0.006; \u03b72 = 0.770). No difference was found between the groups. No significant across timepoints change of expectations was observed in the group who received strongly positive instructions (p = 0.433; \u03b72 = 0.021) or in the group who received positive instructions (p = 0.151; \u03b72 = 0.037). Since the first group had a decrease across timepoints of the score while the second group had a peak at T2, difference between them was statistically significant (p = 0.029; \u03b72 = 0.049). Conclusion: Strongly positive verbal instructions did not produce placebo effect.<\/jats:p>","DOI":"10.1159\/000548932","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T17:01:31Z","timestamp":1763485291000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Placebo Effect of Verbal Instructions Coupled with Pharmacological Treatment: Results from a Randomized Controlled Trial in Migraine Patients"],"prefix":"10.1159","author":[{"given":"Sara","family":"Romanazzo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9501-8272","authenticated-orcid":false,"given":"Francesca","family":"Monti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Ceccatelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"De Cesaris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Chiarugi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5022-0488","authenticated-orcid":false,"given":"Fiammetta","family":"Cosci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/s0031-6997(25)06972-8"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1124\/pr.114.009423"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000490354"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2014.10.023"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1177\/03331024231218392"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2014.01.016"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpsc.2023.08.007"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.02.006"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20160"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1038\/312755a0"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(04)00908-1"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1177\/0333102420960020"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.07.010"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/head.13907"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002341"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.115.10.905"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2016.16020225"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413485658"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419828967"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852919001536"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410379890"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen103"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291700045645"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.09.012"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.0383-12.2012"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1159\/000501385"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000333"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1080\/10503307.2023.2290029"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3006175"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-020-0406-7"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.115"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1159\/000535262"}],"container-title":["Psychotherapy and Psychosomatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000548932","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T17:00:53Z","timestamp":1765904453000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000548932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":32,"URL":"https:\/\/doi.org\/10.1159\/000548932","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.30648965","asserted-by":"subject"}]},"ISSN":["0033-3190","1423-0348"],"issn-type":[{"type":"print","value":"0033-3190"},{"type":"electronic","value":"1423-0348"}],"subject":[],"published":{"date-parts":[[2025,11,18]]}}}