Nocebo and Psychological Factors in Irritable Bowel Syndrome (IBS): A Scoping Review


  • Hamid Nasiri-Dehsorkhi Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen-Iran. Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Shahram Vaziri
  • Ahmad Esmaeilzadeh
  • Peyman Adibi


Aims. A discussion of the definition, existence, prevalence, etiology and characteristics of the nocebo effect in irritable bowel syndrome.

Background. There is considerable information about the interrelation of FGIDS and psychological disorders. Hence, it is called gut-brain interaction. Physiological and psychological variables have been linked with etiology and severity of irritable bowel syndrome. The nocebo effect (the opposite of placebo) is defined as increasing pain or other symptoms after use of an inactive or inert treatment/agent purported to increase pain or unpleasant symptoms. Some psychological mechanisms include expectancies, conditioning, learning, memory, motivation, somatic focus, reward, anxiety reduction and meaning and neurobiological aspects such as cholecystokinergic hyperactivity factors are proposed for etiology of this phenomenon.

Design. This paper following a scoping review of the existence, frequency and importance of nocebo effect in IBS patients.

Data Sources. Literature databases (PubMed, PsycINFO, Google scholar, Scopus) searched from inception dates to 2022.

Implications for practitioners. Psychological factors include expectancies, conditioning, learning, memory and other factors influence the process of diagnosis, course and treatment of functional gastrointestinal disorders such as IBS. Because expectation facilitates the perception of a specific sensation and of stimulus categories, this effect helps clarify why side effects often occur as a cluster of multiple symptoms. Placebo and nocebo responses are mediated by expectations, associative and social observational learning processes, patient’s personality, societal factors and the quality of the patient-physician interaction are important.

Conclusion. Unfortunately, compared to the large number of research data related to the placebo effect, there are less information and articles about the role nocebo, especially in functional gastrointestinal disorders. This paper summarizes the scope and importance of the nocebo effect and IBS and its interrelations with psychological factors like personality, anxiety, depression and psychological distress.

Keywords. Nocebo, IBS, Psychological factors, Personality traits.




How to Cite

Nasiri-Dehsorkhi, H., Vaziri, S. ., Esmaeilzadeh, A. ., & Adibi, P. . (2022). Nocebo and Psychological Factors in Irritable Bowel Syndrome (IBS): A Scoping Review. International Journal of Body, Mind and Culture, 9(4). Retrieved from



Review Article(s)

Most read articles by the same author(s)