Q-No: a questionnaire to predict nocebo in outpatients seeking neurological consultation

Nocebo affects significantly adherence and treatment outcome and varies considerably among neurological conditions. We aimed to evaluate a questionnaire to predict nocebo in outpatients seeking neurological consultation. A four-item (rating range 4-20) self-fulfilled questionnaire (Q-No) was given in outpatients seeking neurological consultation at the Athens Naval Hospital. A blind to Q-No scoring neurologist rated outpatients as nocebo or no-nocebo after follow-up of > 6 months. 341 (71.5 % females) patients with mean age 46.9 (+/- 13.8) years fulfilled the requested follow-up and Q-No. The mean total score was 13.2 (+/- 3.7). The Crombach's alpha coefficient was 0.627. Neurologist suggested 80 patients (23.7 %) as nocebo and 258 as no-nocebo (mean Q-No score = 12.4 95 % CI [12.0-12.9] and 15.8, 95 % CI [15.1-16.6], respectively). Using a cut-off at score 15 the Q-No predicts nocebo with 71.7 % specificity, 67.5 % sensitivity and 42.5 % positive predictive value. Q-No may serve as a useful tool to predict nocebo in outpatients seeking neurological consultation.