Drug, doctor warmth, and clinic setting in the symptomatic response to minor tranquilizers

Karl Rickels, Ronald S. Lipman, Lee C. Park, Lino Covi, E. H. Uhlenhuth, John E. Mock

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

An NIMH-PRB collaborative double-blind clinical trial, concerned with the importance of the "doctor variable" for drug treatment outcome, was conducted with 485 anxious neurotic outpatients receiving either chlordiazepoxide, meprobamate, or placebo. The participating clinics were located at the Johns Hopkins Hospital, Philadelphia General Hospital, and the Hospital of the University of Pennsylvania. The doctor variable selected for presentation was "doctor warmth". Data on the 169 patients completing the 4 week study according to protocol were analyzed using a factorial analysis of covariance procedure, and the main findings were as follows: 1. several main "drug" effects, present only at 2 weeks, indicated chlordiazepoxide to produce significantly more improvement than either meprobamate or placebo; 2. several main "warmth" effects, present only at 4 weeks, showed patients rating their physicians at the initial visit as "warm" to improve significantly more than patients rating their physicians as "non-warm"; and 3. several significant drug X clinic interaction effects at 4 weeks reflected the fact that while hardly any drug differences were seen in 2 clinics, at Philadelphia General Hospital, patients strongly favored chlordiazepoxide. "Drug" and "warmth" effects were particularly marked in initially sicker patients, and "warmth" appeared especially important in the improvement of initially sicker placebo patients.

Original languageEnglish (US)
Pages (from-to)128-152
Number of pages25
JournalPsychopharmacologia
Volume20
Issue number2
DOIs
StatePublished - Jun 1971

Keywords

  • AnxietyNeurosis
  • Chlordiazepoxide
  • Doctor Warmth
  • Meprobamate
  • Placebo

ASJC Scopus subject areas

  • Pharmacology

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