(Science
Daily) The findings of a comprehensive review of the placebo phenomenon
and its consequences for clinical medicine are contained in a new article… The
effort, undertaken by physician-researcher Fabrizio Benedetti…, provides an
in-depth biological and evolutionary approach to examining the placebo effect
in relationship to the doctor-patient relationship…
Among
the issues discussed in detail are:
•
There
is no one "the placebo effect." There are different mechanisms in
play across a variety of medical conditions and therapeutic interventions. For
example, a placebo effect takes place because there is expectation. The patient
expects a therapeutic benefit, and this kind of expectation actually has an
effect on the brain and the body.
•
The
connection between expectation and real improvement that may occur is due at
least to two mechanisms. The first may be a reduction of anxiety. The second is
between expectation and the activation of a reward mechanism by the region of
the brain known as the nucleus accumbens (which also governs pleasure, reinforcement
learning, laughter, addiction, aggression, fear, impulsivity and the placebo
effect.)
•
When
a treatment is given to a patient, be it a placebo or real, it is administered
in a complex set of psychological states that vary from patient to patient and
from situation to situation. For example, when a placebo is given to relieve
pain, it is administered along with stimuli which tell the patient that a
clinical improvement should be occurring shortly. These stimuli can include the
color and shape of the pill, patient and provider characteristics and the
healthcare setting.
•
Recent
research has revealed a reduced efficacy of drugs when they are administered
covertly to the patient. In fact, if the placebo/expectation component of a
treatment is eliminated by means of a hidden administration (unbeknownst to the
patient), the psychological component of the therapy is absent as well.
For
physicians, psychologists, and health professionals these and other recent
findings found in Dr. Benedetti's article can foster enhanced understanding of
how their words, attitudes, and behaviors impact on the physiological profile
of their patients' brains. This "direct vision" of the patient's
brain will hopefully boost health professionals' empathic, humane, and
compassionate behavior further. Moreover, understanding the physiological
underpinnings of the doctor-patient relationship will lead to better medical
practice as well as to better social/communication skills and health policy.
Community: The placebo effect is very
powerful, and I’m glad there’s more research into its effects. If we could
channel it, we could
use it to help prevent or treat some diseases.
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