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Efeitos De Placebo, Curas E Meditação Efeitos de placebo, curas e meditação Placebo effects, healing and meditation O livro “Aquém e Além do Cérebro” contém as atas do 11º Simpósio da Fundação Bial, realizado na Casa do Médico, de 30 de março a 2 de abril de 2016, tendo como membros da Comissão Organizadora os Senhores Professores Fernando Lopes da Silva, Dick Bierman, Miguel Castelo-Branco, Axel Cleeremans, Rainer Goebel, Mário Simões e Caroline Watt. Os textos estão disponíveis em www.fundacaobial.com. The book “Behind and Beyond the Brain” includes the texts of the Bial Foundation’s 11th Symposium, held at Casa do Médico, from March 30th to April 2nd 2016, having as members of its Organizing Committee the following Professors: Fernando Lopes da Silva, Dick Bierman, Miguel Castelo-Branco, Axel Cleeremans, Rainer Goebel, Mário Simões and Caroline Watt. The texts are available at © COPYRIGHT Fundação Bial 2016. Os www. fundacaobial.com. textos são da responsabilidade dos autores, aos quais estão igualmente reservados todos os Foi publicado em 1ª edição pela Fundação respetivos direitos autorais, designadamente Bial com uma tiragem de 2.250 exemplares. noutras edições, em traduções e, de uma forma geral, em reproduções, totais ou parciais, por It was published as 1st edition by Fundação Bial qualquer outro meio. with a print run of 2.250 copies. © COPYRIGHT Fundação Bial 2016. The content of the texts is of the sole responsibility of Execução Gráfica / Printed by: the authors to which all associated copyrights are Rebelo - Artes Gráficas,Lda. reserved namely with respect to other editions, Depósito Legal Nº 421363/17 translations, and more generally in full or partial ISBN 978-972-99286-7-3 reproductions, by any other means. 2 ÍNDICE INDEX SESSÃO DE ABERTURA / OPENING SESSION - Discurso do Presidente da Fundação Bial ........................................................... 9 Luís Portela - Discurso do Presidente da Comissão Organizadora ........................................... 15 Fernando Lopes da Silva - Discurso do Bastonário da Ordem dos Médicos ................................................ 17 José Manuel Silva - Discurso do Presidente do Conselho de Reitores das Universidades Portuguesas .................................................................................. 19 António Cunha - Discurso da Secretária de Estado da Ciência, Tecnologia e Ensino Superior, em representação do Senhor Ministro da Ciência, Tecnologia e Ensino Superior .............................................................................. 21 Maria Fernanda Rollo CONFERÊNCIA INAUGURAL / OPENING CONFERENCE - The emperor’s new drugs: medication and placebo in the treatment of depression ............................................................................ 27 Irving Kirsch PALESTRAS / LECTURES - Teach the T cells: How learning can shape immunity ........................................ 45 Manfred Schedlowski - The neurophysiology of placebo effects: A window on the workings of mind-body medicine ........................................................................................... 59 Tor D. Wager - Neurochemical systems involved in the formation of placebo effects in pain and in Major Depression ............................................................ 77 Jon-Kar Zubieta - The challenge of mapping placebo mechanisms across diseases ...................... 87 Fabrizio Benedetti - Unsolved, forgotten, and/or ignored features of the placebo response in medicine .......................................................................................... 99 Paul Enck et al 5 - Placebo effects in clinical practice .................................................................... 119 Ted Kaptchuk - Placebo science: Magic you can really believe in ............................................. 127 Amir Raz - Placebo analgesia - opportunities and challenges in clinical practice ............. 143 Damien Finniss - Cross-cultural aspects of health and disease .................................................... 149 Tania Re & Antonio Guerci - The possible role of mental influence in evidence-based Medicine ................ 159 Jessica Utts - Healing through meaning: placebo, meditation and distant intentions .......... 169 Stefan Schmidt - Brains and Beyond: The unfolding vision of health and healing .................... 185 Larry Dossey POSTER APRESENTADO PELA FUNDAÇÃO BIAL / POSTER PRESENTED BY THE BIAL FOUNDATION ......................................... 215 LISTA DE POSTERS / POSTERS .................................................................... 219 PALESTRANTES E MODERADORES / SPEAKERS AND MODERATORS - Notas biográficas / Curriculum Vitae ................................................................ 235 Textos disponíveis em www.fundacaobial.com Texts availabe at www.fundacaobial.com 6 SESSÃO DE ABERURA OPENING SESSION DISCURSO DO PRESIDENTE DA FUNDAÇÃO BIAL Luís Portela Boa noite. Bem-vindos ao 11º Simpósio Aquém e Além do Cérebro, sob o tema “Efeitos de placebo, curas e meditação”. Muito obrigado a todos pela vossa presença. Um agradecimento especial à Senhora Secretária de Estado da Ciência, Tecnologia e Ensino Superior, Prof. Maria Fernanda Rollo, que aqui está em representação do Senhor Ministro da Ciência, Tecnologia e Ensino Superior. Muito obrigado pela sua presença e pelo facto de se ter disponibilizado para vir de Lisboa ao Porto no meio deste temporal, apenas para estar connosco, quando eu sei que está com uma agenda muito sobrecarregada. Muito obrigado pela sua presença. Os nossos agradecimentos, por todo o apoio que têm dispensado à Fundação Bial, ao Conselho de Reitores das Universidades Portuguesas, na pessoa do seu Presidente, Prof. António Cunha; e à Ordem dos Médicos, na pessoa do seu Bastonário, Prof. José Manuel Silva. O nosso muito obrigado pela presença do Senhor Presidente da ARS Norte, Dr. António José Pimenta Marinho, que representa o Senhor Secretário de Estado Adjunto e da Saúde, da Senhora Bastonária da Ordem dos Farmacêuticos, Prof.ª Ana Paula Martins - tenho muito gosto que esta seja uma das suas primeiras sessões públicas no desempenho das suas novas funções -, e do Senhor Presidente da Comissão de Coordenação e Desenvolvimento Regional do Norte, Prof. Emídio Gomes. Cumprimento as demais autoridades presentes e também os membros da Comissão Organizadora deste simpósio, a quem manifesto o nosso reconhecido agradecimento pelo excelente trabalho desenvolvido. Um abraço ao seu Presidente, Prof. Fernando Lopes da Silva. Penso que quase todos sabem que a Fundação Bial é uma instituição sem fins lucrativos, criada pela empresa farmacêutica Bial e pelo Conselho de Reitores das Universidades Portuguesas em 1994, tendo em vista incentivar a investigação científica sobre o ser humano saudável, quer sob o ponto de vista físico, quer sob o ponto de vista espiritual. A Fundação é gerida por representantes das duas instituições. 9 OPENING SESSION O que muitos provavelmente não saberão é que esta instituição tem vivido de uma enorme dedicação de um conjunto de pessoas que, ao longo dos anos, tem tornado muito bonito o trabalho que aqui se faz. Pessoas competentes, mas também pessoas de grande dedicação e de grande qualidade interior. Deixem-me lembrar-lhes os nossos dois primeiros administradores, Professores Nuno Grande e Manuel Baganha. Dois seres humanos excecionais que, comigo, idealizaram a constituição da Fundação, com a configuração que ela tem. Depois, foram nossos administradores, durante 16 anos, no caso de Nuno Grande, e 8 anos, no caso de Manuel Baganha. E a estes dois grandes obreiros desta casa, sucederam os Professores Maria de Sousa e Daniel Bessa. E que grande admiração tenho também por estes dois amigos! O Daniel continua em funções, mas a Maria terminou-as, por limite de idade, em 2014. Maria de Sousa é uma grande investigadora na área da Imunologia, que trabalhou perto de vinte anos em Glasgow e em Nova Iorque, mas que, depois, se radicou no Instituto de Ciências Biomédicas Abel Salazar e no IBMC. Com uma elevada produção científica, publicou em muitos sítios, nomeadamente na Nature e na Science. Ao longo da carreira, tem sido diversas vezes distinguida, salientando- -se as condecorações como Grande Oficial da Ordem do Infante D. Henrique (1995) e Grande Oficial da Ordem de Sant’lago da Espada (2012). Mulher de grande inteligência e de grande capacidade de trabalho, bem como de elevado nível de exigência - isso acho que todos nós sabemos muito bem -, assume com grande dedicação, eu diria mesmo com paixão, os projetos em que se envolve. E assim aconteceu na JNICT, quando, sob a batuta do Prof. José Mariano Gago, promoveu uma revolução no sistema de avaliação da ciência em Portugal. Todos lhes ficámos a dever esse notável trabalho. O seu primeiro contacto com a Fundação Bial foi, penso eu, em 1994, quando lhe foi atribuído o nosso Grande Prémio. Depois, foi membro de três júris do Prémio Bial, sendo presidente em 2000. Finalmente, foi nossa administradora entre 2010 e 2014, replicando ao nosso nível o que tinha feito na JNICT: reorganizou as nossas atividades, incutindo-lhes um mais elevado nível de exigência de qualidade. 10 OPENING SESSION A Prof. Maria de Sousa será sempre uma das nossas, embora agora sem funções explícitas. Maria, em meu nome e no da administração da Fundação Bial, muito obrigado por tudo o que realizou em prol da Fundação. Mas, falando de pessoas que têm marcado a vida da Fundação Bial, deixem-me lembrar-lhes as mais de uma centena de personalidades que têm passado pelos nossos Conselhos Científico e Fiscal,
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