Nowadays, numerous definitions of placebo and the placebo effect have been proposed. Mechanisms of action have been intensely studied and interesting theories have emerged. It is well-known that the effects of the drugs are influenced by the clinical setting. The complexity of human mind and the social context make the patient highly suggestible to (auto)suggestion.

To assess factors influencing placebo effect in Romanian patients with mental disorders.

We present 5 clinical cases from our medical practice and compare them to cases from medical literature: 68 years old woman, psychiatric inpatient complaining of insomnia, with medically treated hypertension; 65 years old woman, neurological inpatient complaining of severe back pains that were neurologically uncommon, but impaired her walking and caused sleep disturbances and were not alleviated by a complex and combined analgesic pharmacotherapy; 70 years old woman, known for doctor shopping, came at the Neurology Emergency Department at 1:30 am for headache, foot burns, and abnormal gait; 48 years old man, psychiatric inpatient complaining of ‘paralyzed bowels”, ‘pain in the legs”, and ‘paralyzed muscles” after undergoing a surgical intervention for an abdominal hernia; 50 years old woman, inpatient suffering from schizophrenia at a Chronic Psychiatric Disorders Department, often complaining of headaches. Patients received different forms of placebo therapy.

All patients were placebo-responders. We noticed decrease of placebo effect in some patients in chronic use, and spectacular amelioration of symptoms when there was a high rate of allegiance.

Allegiance is an important factor for placebo effect.