Clifton T. Perkins Hospital Center

With positron emission tomography followed by functional magnetic resonance imaging (fMRI), we demonstrated that rapid eye movements (REMs) in sleep are saccades that scan dream imagery. The brain “sees” essentially the same way while awake and while dreaming in REM sleep. As expected, an event-related fMRI study (events = REMs) showed activation time-locked to REMs in sleep (“REM-locked” activation) in the oculomotor circuit that controls saccadic eye movements and visual attention. More crucially, the fMRI study provided a series of unexpected findings, including REM-locked multisensory integration. REMs in sleep index the processing of endogenous visual information and the hierarchical generation of dream imagery through multisensory integration. The neural processes concurrent with REMs overlap extensively with those reported to be atypical in autism spectrum disorder (ASD). Studies on ASD have shown atypical visual processing and multisensory integration, emerging early in infancy and subsequently developing into autistic symptoms. MRI studies of infants at high risk for ASD are typically conducted during natural sleep. Simply timing REMs may improve the accuracy of early detection and identify markers for stratification in heterogeneous ASD patients. REMs serve as a task-free probe useful for studying both infants and animals, who cannot comply with conventional visual activation tasks. Note that REM-probe studies would be easier to implement in early infancy because REM sleep, which is markedly preponderant in the last trimester of pregnancy, is still pronounced in early infancy. The brain may practice seeing the world during REM sleep in utero before birth. The REM-probe controls the level of attention across both the lifespan and typical-atypical neurodevelopment. Longitudinal REM-probe studies may elucidate how the brain develops the ability to “see” and how this goes awry in autism. REMs in sleep may allow a straightforward comparison of animal and human data. REM-probe studies of animal models of autism have great potential. This narrative review puts forth every reason to believe that employing REMs as a probe into the development of the visual brain will have far-reaching implications.

Despite multiple trials of different adjuvant therapies to an antipsychotic regimen, there have been few promising results. Allopurinol may be one promising adjunctive therapy based on three randomized controlled trials. To determine whether adjuvant allopurinol would be beneficial to a patient already on multiple trials of antipsychotics with no improvement. Allopurinol was started with this particular patient who was on the inpatient unit for over three months with no prior improvement. Within two weeks of allopurinol adjuvant therapy, the patient showed significant improvement with regards to his positive and negative symptoms of schizophrenia (PANSS scores went from a score of 88 to a score of 41 two weeks later). Despite some limitations of this particular case report, it is possible that allopurinol can play an effective role as an adjuvant to antipsychotic regimens in reducing the symptoms of schizophrenia.

Two studies were conducted to investigate the possibility of individual differences in the ability of inpatients to process interactions in group psychotherapy. The first was a pilot study conducted on groups of major depressive patients and matched normal subjects. Subjects were asked to give process comments after viewing simulations of typical group therapy interactions. These comments were later rated on the extent to which they reflected process qualities and accuracy. These data led to a more rigorous and extensive study that included more appropriate control groups as well as measures of potential confounding factors, such as simulation realism, verbal ability, and interaction comprehension. Results indicated that major depressives suffer from deficits in the ability to process group interactions, relative to three types of control groups, including normals. These differences in processing were not significantly positively correlated with any of the potential confounding factors. The implications for understanding interactional processing and group psychotherapy are discussed.

Back to table of contents Previous article Next article AbstractsNo AccessPsychiatric Treatment of Violent Patients in Private PracticeFrancis L. Carney, Ph.D.Francis L. CarneyJessup, Md.Search for more papers by this author, Ph.D.Published Online:30 Apr 2018https://doi.org/10.1176/appi.psychotherapy.1975.29.4.625AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "Psychiatric Treatment of Violent Patients in Private Practice." American Journal of Psychotherapy, 29(4), pp. 625–626 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - APT - American Journal of Psychotherapy $35.00 Add to cart PPV Articles - APT - American Journal of Psychotherapy Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Volume 29Issue 4 1975, pp. 463–643Pages 625-626 Metrics PDF download History Published online 30 April 2018 Published in print 1 October 1975

Back to table of contents Previous article Next article ArticleNo AccessCounseling Through Education In a Maximum-Security HospitalAlbert CohenAlbert CohenSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ps.17.10.306AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - Psychiatric Services $35.00 Add to cart PPV Articles - Psychiatric Services Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Volume 17Issue 10 October 1966Pages 306-309 Metrics PDF download History Published online 1 April 2006 Published in print 1 October 1966