[Psiconeurophysiologic bases of the placebo-nocebo phenomenon: scientific evidences that value the humanization of the doctor-patient relationship].
Aspect quite valued in the medical systems of all of the times, the doctor-patient relationship assumed secondary importance in the current biomedical model, depriving the modern therapeutic arsenal of a psyconeurophisiological intervention capable to complement the resolution of many organic disturbances. With the intention of rescuing this and other benefits, countless proposed by the humanization of the medicine have been appearing in the several sections of the health, remaining to scientific thought accept that this subjective relational increment can increase the effectiveness of the conventional treatments. Working as sensitization element, the recent experimental studies illustrate the possible benefits or harms that a doctor-patient relationship more or less humanized can provoke in the evolution of the diseases. Uniting the theories of classical conditioning and conscious expectation, the researches suggest that the doctor's posture, permeated by positive or negative manifestations (comments, suggestions, attitudes etc.), it can exercise similar influences in the patients' psyche, unchaining favorable or unfavorable neurophysiologic answers, acting as therapeutic or iatrogenic instrument, respectively.
Hospital das Clinicas da FMUSP - Servico de Clinica Medica Geral, Instituto Central, Predio dos Ambulatorios, Sao Paulo, Brazil. marcus@homeozulian.med.br
Marcus Zulian
MZ
Teixeira
D002985:Clinical Protocols; D018849:Controlled Clinical Trials as Topic; D003863:Depression / Q000523:psychology; D019317:Evidence-Based Medicine; D006808:Humanism; D006801:Humans; D010300:Parkinson Disease / Q000523:psychology; D010817:Physician-Patient Relations / Q000941:ethics*; D015990:Placebo Effect; D010919:Placebos / Q000627:therapeutic use*
D010919:Placebos