Differential power of placebo across major psychiatric disorders: a preliminary meta-analysis and machine learning study.

Journal: Scientific reports
PMID:

Abstract

The placebo effect across psychiatric disorders is still not well understood. In the present study, we conducted meta-analyses including meta-regression, and machine learning analyses to investigate whether the power of placebo effect depends on the types of psychiatric disorders. We included 108 clinical trials (32,035 participants) investigating pharmacological intervention effects on major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SCZ). We developed measures based on clinical rating scales and Clinical Global Impression scores to compare placebo effects across these disorders. We performed meta-analysis including meta-regression using sample-size weighted bootstrapping techniques, and machine learning analysis to identify the disorder type included in a trial based on the placebo response. Consistently through multiple measures and analyses, we found differential placebo effects across the three disorders, and found lower placebo effect in SCZ compared to mood disorders. The differential placebo effects could also distinguish the condition involved in each trial between SCZ and mood disorders with machine learning. Our study indicates differential placebo effect across MDD, BD, and SCZ, which is important for future neurobiological studies of placebo effects across psychiatric disorders and may lead to potential therapeutic applications of placebo on disorders more responsive to placebo compared to other conditions.

Authors

  • Bo Cao
    Department of Psychiatry, University of Alberta, Edmonton, Canada.
  • Yang S Liu
    Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Alessandro Selvitella
    Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Diego Librenza-Garcia
    Graduation Program in Psychiatry, Universidade Federal das Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, 90035-903, Brazil. Electronic address: diegolibrenzagarcia@gmail.com.
  • Ives Cavalcante Passos
    Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA; Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
  • Jeffrey Sawalha
    Department of Psychiatry, University of Alberta, Alberta, Canada.
  • Pedro Ballester
    Machine Intelligence and Robotics Research Group, School of Technology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
  • Jianshan Chen
    Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Shimiao Dong
    Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Fei Wang
    Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States.
  • Flávio Kapczinski
    Bipolar Disorder Program and Laboratory of Molecular Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
  • Serdar M Dursun
    Department of Psychiatry, University of Alberta, Edmonton, Canada.
  • Xin-Min Li
    Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Russell Greiner
    Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif.
  • Andrew Greenshaw
    Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.