Belcher Annabelle M, Ferré Sergi, Martinez Pedro E, Colloca Luana
Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, USA.
National Institute on Drug Abuse, National Institutes of Health, Bethesda, USA.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Dec 20;87(Pt B):298-306. doi: 10.1016/j.pnpbp.2017.06.003. Epub 2017 Jun 14.
The placebo (and the nocebo) effect is a powerful determinant of health outcomes in clinical disease treatment and management. Efforts to completely eradicate placebo effects have shifted dynamically, as increasingly more researchers are tuned to the potentially beneficial effects of incorporating those uncontrollable placebo effects into clinical therapeutic strategies. In this review, we highlight the major findings from placebo research, elucidating the main neurobiological systems and candidate determinants of the placebo phenomenon, and illustrate a perspective that can effectively frame future research on the topic. Finally, we issue a call for increased research on the efficacy of therapeutic strategies that incorporate placebo "tools," and argue that clinical trials of the placebo response in neuropsychiatric diseases and disorders has important and far-reaching translational and clinical relevance.
安慰剂(和反安慰剂)效应是临床疾病治疗和管理中健康结果的一个重要决定因素。随着越来越多的研究人员关注将那些无法控制的安慰剂效应纳入临床治疗策略的潜在益处,彻底消除安慰剂效应的努力也在动态变化。在本综述中,我们重点介绍了安慰剂研究的主要发现,阐明了安慰剂现象的主要神经生物学系统和候选决定因素,并阐述了一个能够有效构建该主题未来研究的观点。最后,我们呼吁加强对采用安慰剂“工具”的治疗策略疗效的研究,并认为对神经精神疾病和障碍中安慰剂反应的临床试验具有重要且深远的转化和临床意义。