Les mécanismes de l’effet placebo

BOSTON – Pour de nombreux chercheurs en médecine et passionnés de science, l’effet placebo est l’un des plus troublants qui soit. Comment une pilule de sucre inerte peut-elle avoir une action thérapeutique ? Pour répondre à cette question, il faut comprendre le contexte entourant les traitements médicaux – l’environnement dans lequel les symboles et les rituels des soins s’associent aux fortes réactions émotionnelles qui se produisent lors de la rencontre entre soignant et soigné. La confiance, l’empathie, l’espoir, la peur, l’appréhension et l’incertitude sont des sentiments qui ne doivent pas être sous-estimés dans la rencontre thérapeutique.

Un utilisant des pilules de sucre, des injections de solution saline et même des simulacres d’intervention chirurgicale, la recherche sur l’effet placebo dissocie la prestation de soins des effets directs de procédures médicales ou de médicaments réels. De récentes recherches sur l’effet placebo ont démontré  que la seule rencontre clinique – sans prestation de « vrai » traitement – peut alléger la douleur, améliorer le sommeil, soulager la dépression et diminuer les symptômes d’un large éventail de pathologies, dont le syndrome du côlon irritable, l’asthme, la maladie de Parkinson, les troubles cardiaques et la migraine.

Les placebos influent surtout sur l’évaluation que font les patients de leur état de santé. Ils ne peuvent réduire une tumeur ; mais ils peuvent aider les malades à moins ressentir la fatigue, les nausées, la douleur et l’anxiété liées au cancer et à son traitement. Ils ne peuvent abaisser le taux de cholestérol ou la tension artérielle, mais ont la capacité de modifier suffisamment l’humeur ou la douleur pour induire un mode de vie plus sain.

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