Frisaldi Elisa, Piedimonte Alessandro, Benedetti Fabrizio
a University of Turin Medical School , Turin , Italy.
Am J Clin Hypn. 2015 Jan;57(3):267-84. doi: 10.1080/00029157.2014.976785.
Placebo and nocebo effects have recently emerged as an interesting model to understand some of the intricate underpinnings of the mind-body interaction. A variety of psychological mechanisms, such as expectation, conditioning, anxiety modulation, and reward, have been identified, and a number of neurochemical networks have been characterized across different conditions, such as pain and motor disorders. What has emerged from the recent insights into the neurobiology of placebo and nocebo effects is that the psychosocial context around the patient and the therapy, which represents the ritual of the therapeutic act, may change the biochemistry and the neuronal circuitry of the patient's brain. Furthermore, the mechanisms activated by placebos and nocebos have been found to be the same as those activated by drugs, which suggests a cognitive/affective interference with drug action. Overall, these findings highlight the important role of therapeutic rituals in the overall therapeutic outcome, including hypnosis, which may have profound implications both in routine medical practice and in the clinical trials setting.
安慰剂和反安慰剂效应最近已成为一种有趣的模型，用于理解心身相互作用的一些复杂基础。人们已经确定了多种心理机制，如期望、条件作用、焦虑调节和奖赏，并且在不同病症（如疼痛和运动障碍）中对一些神经化学网络进行了表征。最近对安慰剂和反安慰剂效应神经生物学的深入研究表明，患者和治疗周围的社会心理背景，即治疗行为的仪式，可能会改变患者大脑的生物化学和神经回路。此外，已发现安慰剂和反安慰剂激活的机制与药物激活的机制相同，这表明存在对药物作用的认知/情感干扰。总体而言，这些发现凸显了治疗仪式在整体治疗结果中的重要作用，包括催眠，这可能在常规医疗实践和临床试验环境中都具有深远意义。
