The Placebo Effect in Mental Health: Psychological, Neurobiological, and Ethical Aspects

Jakša Dubljanin; Aleksandar Radlović; Nemanja Nenezić; Emir Biševac; Elvis Mahmutović; Teodora Safiye

doi:10.5937/arhfarm76-61024

Jakša Dubljanin University of Kragujevac - Faculty of Medical Sciences, Kragujevac, Serbia https://orcid.org/0000-0002-5767-7798
Aleksandar Radlović University of Kragujevac - Faculty of Medical Sciences, Kragujevac, Serbia https://orcid.org/0009-0008-2721-0469
Nemanja Nenezić Department of Medical Studies Ćuprija, Academy of Educational and Medical Vocational Studies Kruševac, Ćuprija, Serbia
Emir Biševac State University of Novi Pazar, Department of Biomedical Sciences, Novi Pazar, Serbia https://orcid.org/0000-0002-3762-5456
Elvis Mahmutović State University of Novi Pazar, Department of Biomedical Sciences, Novi Pazar, Serbia https://orcid.org/0000-0003-1849-868X
Teodora Safiye State University of Novi Pazar, Department of Psychology, Novi Pazar, Serbia https://orcid.org/0000-0002-9297-8449

DOI: https://doi.org/10.5937/arhfarm76-61024

Keywords: placebo effect, neurobiological aspects, psychological mechanisms, mental health, psychotherapy

Abstract

The placebo effect is a psychobiological phenomenon in which patients’ expectations, prior experiences, and social context influence health outcomes, even in the absence of active pharmacological treatment. Key mechanisms include expectancy, verbal suggestion, classical conditioning, and social-contextual factors, underpinned by neurobiological processes involving endogenous opioids, dopamine, and related neural circuits. In mental health and psychotherapy, placebo effects are particularly relevant, as the therapeutic alliance, empathy, and belief in treatment can significantly enhance outcomes. Ethical applications such as open-label and dose-extending placebos preserve patient autonomy while leveraging expectancy and learning to improve clinical results. Recognizing and integrating placebo mechanisms into clinical practice highlights the interaction of psychological, neurobiological, and ethical factors, offering a holistic approach to treatment and enhancing therapy outcomes in conditions like depression, anxiety, and chronic pain.

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