Thinking about death can kill you

Many people self-hex themselves to death. The phenomenon is called "the nocebo effect" and it involves the often-fatal impact of the firm, and usually false, belief that one is suffering from a deadly disease or lethal body malfunction.

According to researchers at the Vanderbilt School of Medicine, some people succumb because they are firmly convinced they are terminally ill, that their end is imminent, even though that belief is groundless.

Robert Hahn, of the United States Centres for Disease Control, confirms that if a person firmly believes he or she is ill, or about to die, that belief can seal their fate, often very rapidly. Individuals who expect to contract a serious disease are much more likely to do so compared with those who do not have such a belief.

Whereas the "placebo effect" induces patients to achieve recovery from diseases by means of treatments involving inert or inactive medications or therapies, the nocebo effect achieves serious or fatal health complications though a self-imposed mindset of presumed inevitability. Both effects stem from self-persuasion and delusion, the latter involving medical conditions that do not, in fact, exist.

According to the Centres for Disease Control, many patients who suffer serious or debilitating disorders do so because they have been convinced to expect them. If health-care professionals, or trusted friends, convincingly generate the suspicion of pending death, that belief becomes firmly cemented in an individual's mindset. Death sometimes follows shortly thereafter, and subsequent autopsies confirm the suspected ailment is either absent or impotent.

Evil-eye death has a long history, and is often related to culture-specific sociological conditions.

But, the nocebo effect, on the other hand, is often generated by the mere delivery of a physician's negative prognosis. According to cancer specialist G.W. Milton, many patients die prematurely, apparently as a direct result of learning about their prognosis rather than due to the malignancy itself.

Psychiatrist Arthur Barsky, at Brigham and Women's Hospital in Boston, says when people are certain something is wrong with their health, it is often a self-fulfilling prophecy.

The nocebo effect sometimes involves unintended responses to medication. According to researchers at Duke University, drug responses can be "manipulated by verbal suggestion (and) nocebo-like effects may be possible due to the suggestive nature of information."

The researchers, who included specialist S.B. Haga and L.R. Warner, warned that "a patient's perceived understanding of test results, and the manner in which they are communicated, may influence therapeutic outcomes."

Researchers at Harbin Medical University report that up to 80 per cent of hospitalized patients, when given sugar-water and told it was an emetic (vomit-enducing substance), subsequently vomited. Studies at Mount Sinai School of Medicine show that 60 per cent of patients on chemotherapy actually begin to feel nausea before treatment commences, a phenomenon called anticipated nausea.

Researchers at the department of psychiatry at the University of Mississippi reported that a 26-year-old man suffered acute hypertension on the belief that he had swallowed 29 anti-depressant capsules. Intravenous fluids were administered to treat his condition, which suddenly disappeared when he learned the pills were in fact inert.

Scientists agree the nocebo effect is generated in the human imagination, and that its impact can sometimes be altered by a person's personal optimism or pessimism.

In one study, women who believed a heart attack was imminent were four times more likely to succumb compared with women who did not share that belief in pending doom, even though both groups had identical risk factors.

Recently, some researchers have been wondering about possible nocebo-effect mortalities among smokers of tobacco products, their mindsets sculpted by massive media coverage of health risks associated with smoking. Nocebo-effect mortality in smokers has not so far been confirmed.

Robert Alison has a PhD in zoology and is based in Victoria, B.C.

Republished from the Winnipeg Free Press print edition August 2, 2009 A13