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Book ChapterDOI

Schizophrenia: perchance a dream?

01 Jan 1975-International Review of Neurobiology (Int Rev Neurobiol)-Vol. 17, pp 297-342
TL;DR: The results support the hypothesis that most actively ill schizophrenic patients fail to have a normal REM rebound following deprivation of REM sleep, and the relationship between the abnormality of REM compensation and hypothesized biochemical abnormalities in schizophrenia is discussed.
Abstract: Publisher Summary This chapter presents the results of a clinical study, which suggest that schizophrenia is related to an abnormality in rapid eye movement (REM) sleep, the stage of sleep most closely associated with dreaming. The hallucinations of the psychotic are compared with the hallucinations experienced by everyone at night in dreams. The chapter addresses the question if schizophrenic patients have a normal rebound of REM sleep following deprivation of REM sleep. The results support the hypothesis that most actively ill schizophrenic patients fail to have a normal REM rebound following deprivation of REM sleep. The evidence is most clear in the study of experimental deprivation of REM sleep, but it is also suggested by the longitudinal study of the two acute schizophrenic patients. Some overlap exists, however, between the actively ill schizophrenics and other psychiatric patients. The relationship between the abnormality of REM compensation and hypothesized biochemical abnormalities in schizophrenia is discussed in the chapter.
Citations
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Journal ArticleDOI
TL;DR: The visual hallucinations that coincide with daytime episodes of REM sleep in patients who also experience post-REM delusions at night may be dream imagery and Psychosis in patients with PD may reflect a narcolepsy-like REM sleep disorder.
Abstract: Background: Patients with PD can have disabling visual hallucinations associated with dopaminergic therapy. Sleep disorders, including vivid dreams and REM sleep with motor behaviors (RBD), are frequent in these patients. Methods: The association of hallucinations and REM sleep both at night and during the day was examined in 10 consecutive nondemented patients with long-standing levodopa-responsive PD and hallucinations. Seven patients presented with paranoia and paranoid delusions. Overnight sleep recordings and standard multiple daytime sleep latency test were performed. The results were compared to those of 10 similar patients with PD not experiencing hallucinations. Results: RBD was detected in all 10 patients with hallucinations and in six without. Although nighttime sleep conditions were similar in both groups, hallucinators tended to be sleepier during the day. Delusions following nighttime REM period and daytime REM onsets were observed in three and eight of the hallucinators, and zero and two of the others. Daytime hallucinations, coincident with REM sleep intrusions during periods of wakefulness, were reported only by hallucinators. Postmortem examination of the brain of one patient showed numerous Lewy bodies in neurons of the subcoeruleus nucleus, a region that is involved in REM sleep control. Conclusion: The visual hallucinations that coincide with daytime episodes of REM sleep in patients who also experience post-REM delusions at night may be dream imagery. Psychosis in patients with PD may therefore reflect a narcolepsy-like REM sleep disorder.

393 citations

Journal ArticleDOI
TL;DR: Results support the role of insomnia in the development of additional psychological problems and highlight the clinical implications for combat veterans, to include the importance of longitudinal assessment and monitoring of sleep disturbances, and the need for early intervention.
Abstract: Objectives: The study conducted a longitudinal assessment of insomnia as an antecedent versus consequence of posttraumatic stress disorder (PTSD) and depression symptoms among combat veterans. Design: Two postdeployment time points were used in combination with structural equation modeling to examine the relative strength of two possible directions of prediction: insomnia as a predictor of psychological symptoms, and psychological symptoms as a predictor of insomnia. Participants were active duty soldiers (N 5 659) in a brigade combat team who were assessed 4 months after their return from a 12-month deployment to Iraq, and then again eight months later. Results: Although both insomnia and psychological symptoms were associated at both time periods and across time periods, insomnia at 4 months postdeployment was a significant predictor of change in depression and PTSD symptoms at 12 months postdeployment, whereas depression and PTSD symptoms at 4 months postdeployment were not significant predictors of change in insomnia at 12 months postdeployment. Conclusions: Results support the role of insomnia in the development of additional psychological problems and highlight the clinical implications for combat veterans, to include the importance of longitudinal assessment and monitoring of sleep disturbances, and the need for early intervention. & 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1240‐1258, 2011.

232 citations


Cites background from "Schizophrenia: perchance a dream?"

  • ...…similarity between dreaming and psychosis have led numerous researchers to propose that various psychological symptoms result from an intrusion of dreaming into wakefulness (Dement et al., 1969; Gillin & Wyatt, 1975; Howland, 1997; Mahowald, Woods, & Schenck, 1998; Saucerman, 1997; Watson, 2001)....

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Journal ArticleDOI
TL;DR: Electroencephalographic sleep in drug-naive and previously medicated schizophrenics had significantly greater impairment of sleep continuity and shorter rapid eye movement latency when compared with controls, and findings were significantly influenced by duration of drug-free status.
Abstract: Polysomnographic abnormalities in schizophrenia are not well characterized and their associations with schizophrenic symptomatology have not been adequately assessed. To address these issues, we recorded electroencephalographic sleep in 20 drug-naive schizophrenics, 20 drug-free but previously medicated schizophrenics, and 15 normal controls. Drug-naive and previously medicated patients had significantly greater impairment of sleep continuity and shorter rapid eye movement latency when compared with controls. In the previously medicated group, findings were significantly influenced by duration of drug-free status. Rapid eye movement latency was inversely correlated with the severity of negative symptoms (r = -.52) but was unrelated to depressive symptoms. Slow-wave sleep did not differ between schizophrenic patients and normal controls and was unrelated to any clinical parameter. Mechanisms underlying the observed associations between rapid eye movement sleep abnormalities and negative symptoms in the acute phase of schizophrenic illness need to be explored.

197 citations

Journal ArticleDOI
TL;DR: It is suggested that young, never-medicated schizophrenics do not show the characteristic constellation of abnormalities in the first NREM-REM cycle seen in patients with major depression, however, decreased slow-wave sleep should be investigated as a possible marker for negative symptoms in schizophrenia.
Abstract: • Electroencephalographic (EEG) sleep characteristics of young, never-medicated, nonschizoaffective schizophrenics were compared with the EEG sleep of patients with major depressive disorders (delusional and nondelusional) and with that of healthy controls. Schizophrenics had decreased sleep continuity comparable to delusional depressives. Slow-wave sleep percent was similar to that seen in healthy controls, as was the intranight temporal distribution of EEG delta activity. However, schizophrenics showed diminished delta counts per minute of non-rapid eye movement (NREM) sleep and a decreased total delta wave count. In contrast, depressives showed diminished slow-wave sleep percent compared with controls, greatly decreased delta activity (more so than did the schizophrenics), and an altered temporal distribution of delta activity, as evidenced by a shift of delta activity from the first to the second NREM period. Minutes of slow-wave sleep in the schizophrenics was inversely correlated with the severity of negative symptoms independent of the effects of age and the presence of depression. The schizophrenics showed normal REM latency and first REM period duration, in contrast to the depressives. These findings, reviewed in the historical context of sleep physiologic studies of schizophrenia over the past 30 years, suggest that young, never-medicated schizophrenics do not show the characteristic constellation of abnormalities in the first NREM-REM cycle seen in patients with major depression. However, decreased slow-wave sleep should be investigated as a possible marker for negative symptoms in schizophrenia.

189 citations

References
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Journal ArticleDOI
04 Sep 1953-Science
TL;DR: A method of gravimetric planimetry by standard photographs offers a means to study the course of surface wounds more accurately than by clinical observation or by the pictorial record alone.
Abstract: obtain their surface in square centimeters. This simple method provides a means by objective measurements to make evident changes in the surface of wounds that are not apparent to the naked eye. Figure 1 shows the observations recorded with this method in a man of 42 years of age with hemiplegia and a decubital ulcer over the right buttock. The clinicians who had observed this wound daily had not noticed any remarkable change; however, it is quite obvious that the wound grew larger each time the treatment was changed, and that the use of an antibiotic was followed by a particularly striking enlargement of the lesion. In this instance the procedure of projection and gravimetric planimetry was repeated by different operators and a variation of ±5% was found (indicated by a cross-hatched area on Fig. 1). Figure 2 shows the same type of observation in a woman with hemiplegia and a decubital ulcer. This patient died from septicemia, and the decubital ulcer worsened with the general condition of the patient. A method of gravimetric planimetry by standard photographs offers a means to study the course of surface wounds more accurately than by clinical observation or by the pictorial record alone. References

2,201 citations

Journal ArticleDOI
TL;DR: This discussion is going to revolve about serotonsin,5 or enteramine, if Erspamer's terminology is followed, and the occurrence and importance of serotonin, a second general idea is prerequisite to this discussion.
Abstract: Recent findings in this laboratory1' 2 and elsewhere3 , 4have permitted an understanding of some aspects of mental diseases in relation to the hormone-like compound, serotonin. Furthermore, these findings lead directly to a suggestion for a logical treatment of diseases known as \"schizophrenia.\" The experimental observations have been made solely on laboratory animals, but they have reached a point where clinical trials in human psychiatric patients are required to test the validity of the conclusions. Being only biochemists, we are unable to do these experiments on patients and can only hope that this paper will stimulate those who are professionally qualified to undertake in man what we cannot pursue further in laboratory animals. This discussion is going to revolve about serotonsin,5 or enteramine, if Erspamer's terminology is followed.6 Serotonin is one of the latest hormone-like substances to be discovered. Chemically it has been shown to have the structure given in Figure 1.7 Being a simple molecule, it has been synthetically produced without great difficulty8' 9 and is thus readily available. It was discovered because it is the vasoconstrictor long known to form in the serum when blood clots. Erspamer's works with it, done independently of that of Rapport, et al.,5 on the vasoconstrictor material, was based on the abundant occurrence of this new compound in the enterochromaffinic cells of the gastric and intestinal mucosa. Serotonin has now been isolated from several different organs, including the brain, of a wide variety of animal forms.'0-'2 There can be no doubt of its wide-spread occurrence in living things. Furthermore, a variety of pharmacological properties in isolated organs and tissues has been demonstrated, in addition to the vasoconstrictor effect. 13 The pharmacological properties which have been described thus far are attributable in large part to the ability of serotonin to cause various smooth muscles to contract; but there are indications that it has other effects which may become more clearly defined as time for study of them goes by. Aside from the occurrence and importance of serotonin, a second general idea is prerequisite to this discussion. It is now well known that several classes of drugs are related. chemically to individual hormones and other essential metabolites.14' 15 In fact, a major part of the pharmacological effects of these drugs is attributed to a specific interference with the biological functioning of these metabolites to which the drugs are related structurally. That is, the drugs are antimetabolites. Our thinking and experimentation about certain mental disorders has been in the following vein. Several synthetic compounds have been produced which are very closely related in structure to serotonin. These were shown to antagonize, in a competitive fashion, the contractions of artery walls caused by serotonin.16' 17 Also, the fact that the ergot alkaloids are structurally related to serotonin Was appreciated, and it was demonstrated that several of these actually did antagonize

586 citations

Journal ArticleDOI
TL;DR: The author discusses some implications of the roles dopamine and norepinephrine may play in mediating some schizophrenic symptoms.
Abstract: Because of its close clinical similarity to acute paranoid schizophrenia, amphetamine psychosis may serve as a useful experimental model for schizophrenia. Molecular and clinical studies suggest that both the schizophrenia-like symptoms of amphetamine psychosis and the specific ability of phenothiazines to relieve the symptoms of schizophrenia and amphetamine psychosis may be the result of interactions with dopamine systems in the brain. The author discusses some implications of the roles dopamine and norepinephrine may play in mediating some schizophrenic symptoms.

577 citations

Journal ArticleDOI
10 Jun 1960-Science

561 citations

Trending Questions (1)
How long can a schizophrenic go without sleep?

The evidence is most clear in the study of experimental deprivation of REM sleep, but it is also suggested by the longitudinal study of the two acute schizophrenic patients.