Psycho-Neuro-Endocrine-Immunological Basis of the Placebo Effect: Potential Applications beyond Pain Therapy.

The placebo effect can be defined as the improvement of symptoms in a patient after the administration of an innocuous substance in a context that induces expectations regarding its effects. During recent years, it has been discovered that the placebo response not only has neurobiological functions on analgesia, but that it is also capable of generating effects on the immune and endocrine systems. The possible integration of changes in different systems of the organism could favor the well-being of the individuals and go hand in hand with conventional treatment for multiple diseases. In this sense, classic conditioning and setting expectations stand out as psychological mechanisms implicated in the placebo effect. Recent advances in neuroimaging studies suggest a relationship between the placebo response and the opioid, cannabinoid, and monoaminergic systems. Likewise, a possible immune response conditioned by the placebo effect has been reported. There is evidence of immune suppression conditioned through the insular cortex and the amygdala, with noradrenalin as the responsible neurotransmitter. Finally, a conditioned response in the secretion of different hormones has been determined in different studies; however, the molecular mechanisms involved are not entirely known. Beyond studies about its mechanism of action, the placebo effect has proved to be useful in the clinical setting with promising results in the management of neurological, psychiatric, and immunologic disorders. However, more research is needed to better characterize its potential use. This review integrates current knowledge about the psycho-neuro-endocrine-immune basis of the placebo effect and its possible clinical applications.

Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine-Immune Therapeutic Mechanisms and Clinical Implications.

Electroconvulsive therapy (ECT) is based on conducting an electrical current through the brain to stimulate it and trigger generalized convulsion activity with therapeutic ends. Due to the efficient use of ECT during the last years, interest in the molecular bases involved in its mechanism of action has increased. Therefore, different hypotheses have emerged. In this context, the goal of this review is to describe the neurobiological, endocrine, and immune mechanisms involved in ECT and to detail its clinical efficacy in different psychiatric pathologies. This is a narrative review in which an extensive literature search was performed on the Scopus, Embase, PubMed, ISI Web of Science, and Google Scholar databases from inception to February 2022. The terms "electroconvulsive therapy", "neurobiological effects of electroconvulsive therapy", "molecular mechanisms in electroconvulsive therapy", and "psychiatric disorders" were among the keywords used in the search. The mechanisms of action of ECT include neurobiological function modifications and endocrine and immune changes that take place after ECT. Among these, the decrease in neural network hyperconnectivity, neuroinflammation reduction, neurogenesis promotion, modulation of different monoaminergic systems, and hypothalamus-hypophysis-adrenal and hypothalamus-hypophysis-thyroid axes normalization have been described. The majority of these elements are physiopathological components and therapeutic targets in different mental illnesses. Likewise, the use of ECT has recently expanded, with evidence of its use for other pathologies, such as Parkinson's disease psychosis, malignant neuroleptic syndrome, post-traumatic stress disorder, and obsessive-compulsive disorder. In conclusion, there is sufficient evidence to support the efficacy of ECT in the treatment of different psychiatric disorders, potentially through immune, endocrine, and neurobiological systems.

Percepción de autoeficacia vs. rechazo del uso del condón en las prácticas sexuales de mujeres y hombres jóvenes / Self-efficacy perception vs. rejection of condom use in the sexual practices of young women and men

Resumen En las relaciones sexuales de jóvenes, las variables asociadas al uso del condón son diversas y comúnmente se presentan con otras variables que, a su vez, se asocian con la práctica sexual desprotegida. Los objetivos de este estudio consistieron en determinar en qué medida la percepción de autoeficacia, la baja percepción de riesgo y el rechazo del uso del condón se relacionan con el uso del condón en las relaciones sexuales de jóvenes colombianos. Participaron en él 308 estu diantes universitarios de la ciudad de Cúcuta, Colombia. Los resultados indican correlaciones significativas en hombres entre el uso del condón y la percepción de autoeficacia, y correlaciones negativas en mujeres entre el uso del condón, la baja percepción de riesgo y el rechazo del uso del condón. Solo en el grupo de hombres, la percepción de autoeficacia predice el uso del condón.

Abstract In the sexual relations of the youth, the variables associated with condom use are diverse and are often presented with other variables, that are also associated with unprotected sexual practice. This study aimed to determine to what extent the perception of self-efficacy, low risk perception and condom use shunning are associated with condom use in sexual relations of young Colom bians. 308 university students in the city of Cúcuta, Colombia, participated in the study. The results indicate significant correlations in men between condom use and self-efficacy perception and negative correlations in women between condom use, low risk perception and condom use shunning. Only in the male groups, the perception of self-efficacy predicts condom use.