[Placebo response - Mechanisms and clinical applications].

Area of Science:

• Psychoneuroimmunology
• Clinical Psychology

Background:

• Placebo responses are complex psychobiological events.
• They are influenced by the overall therapeutic context and can occur outside of experimental settings.
• Research indicates patients exhibit higher and longer-lasting placebo responses than healthy individuals, particularly for analgesia.

Purpose of the Study:

• To explore the role of psychological mechanisms in placebo responses.
• To investigate the potential of placebo responses as an adjunct to pharmacological treatments.
• To examine the transferability and reproducibility of placebo effects from healthy participants to patients.

Main Methods:

• Review of recent research on placebo responses, focusing on analgesia.
• Analysis of psychological mechanisms inducing placebo effects: instructions, classical conditioning, and social learning.
• Discussion of neurobiological underpinnings of expectation modulation on pain perception.

Main Results:

• Expectations are a key driver of placebo analgesia, modulated by psychological mechanisms.
• Positive expectations lead to pain relief, while negative expectations can cause the nocebo effect.
• Psychological mechanisms may also influence itch-reducing placebo responses.

Conclusions:

• Placebo responses can be intentionally induced and utilized in clinical practice.
• They should be considered as complementary to, rather than competitive with, medications.
• Ethical application requires transferability of findings from healthy subjects to patients and reproducible effects.