The placebo problem in child and adolescent psychiatry.

This paper is part of a special section on 'psychopharmacotherapy in children'. In contrast to adult psychiatry, research of placebo uses and effects in child and adolescent psychiatry is practically nonexistent, except in the context of clinical drug trials. Any type of therapy in pedopsychiatry may have positive or negative placebo effects, not only on the patients but also on their parents, teachers and therapists. The use of placebo in this population has controversial clinical, research, ethical and legal implications. Pedopsychiatrists should achieve consensus related to the clinical and research uses of placebo in their patients. Further research is needed to clarify the specific and nonspecific placebo factors related to short-term and long-term treatment outcome.