The placebo effect is everywhere, but some things amplify it, and knowing how to spot them

can keep the treatment on the right path.

Welcome to the Carlatte Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Saken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

I've been in practice for 25 years, and for most of that time, I've made it a habit to rate symptoms at every visit.

That means years of ratings and thousands of patients.

And today I'm going to share two patterns I've seen that can help you separate the real

medication effects from the placebo effect a little better.

The placebo effect is not evenly distributed. Some disorders are more responsive to it than others.

Last year, Tom Beshore and colleagues from Germany ranked the placebo effect for each major

psychiatric disorder. At the top, a major depression and generalized anxiety, with an effect

size of 1.2 to 1.4. That's larger than the effect of adderol in ADHD.

By comparison, the effect size for antidepressants are small, around 0.3.

That placebo effect is even higher for children and for mild depression,

but it falls a bit lower in treatment-resistant depression.

Next come diagnoses in the middle, where the placebo effect is still large,

around 0.7 to 0.9.

Those are panic disorder, ADHD,

PTSD, social anxiety, and mania.

Yep, mania.

Most mania trials are done in the hospital, where a structured

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