Biomedical subjects
C Pearlman
Publications and source records attributed to C Pearlman.
Clozapine, nocturnal sialorrhea, and choking.
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Neuroleptic malignant syndrome.
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A research-based reconsideration of the psychoanalytic theory of dreaming.
We present a brief review of sleep research which, when combined with psychoanalytic experience, has led to the hypothesis that REM sleep and dreaming serve the function of adaptation by the process of integration of information. We then report the results of a study of dreams, based on this hypothesis. We studied dreams and their relation to waking mental activity and found a correlation between problems in manifest dreams and those in pre- and postsleep waking life. Dreams can be understood on the basis of problems that appear in them. We also found evidence for a relation between the solution of problems in dreams and the fate of those problems the next day. We discuss these findings in relation to some of the controversies about dreaming, and then present suggestions for future research.
Electroconvulsive therapy. Current concepts.
Recent developments in the practice and theory of ECT are reviewed. Indications, efficacy, and risk/benefit considerations are discussed with emphasis on the clinical utility and cost-effectiveness of increased and earlier usage of ECT in hospitalized patients. Treatment procedures are presented in some detail with listings of medical considerations, management of complications, and other applications to general hospital practice. Research on the mechanism of action, potential future developments, and some training issues are briefly discussed.
Depression: variability of intrapsychic and sleep parameters.
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Creatine kinase elevation after neuroleptic treatment.
Two cases of asymptomatic elevation of creatine kinase levels after oral neuroleptic treatment are described. One patient was successfully challenged with a different neuroleptic. The authors discuss possible reasons for creatine kinase elevation.
High-dosage tranylcypromine in refractory depression.
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Hyperthyroidism in a patient with agitated depression: resolution after electroconvulsive therapy.
A patient with hyperthyroidism is described whose clinical presentation was that of agitated depression. Her psychologic abnormality and thyroid hyperfunction responded to electroconvulsive therapy.
The capacity of stroke patients to report dreams.
We studied the capacity of stroke patients to report dreams following awakening from REM sleep. Four left-hemisphere aphasia and two right-hemisphere visuospatial deficit patients reported dreams. The expression of ideas in dreams appeared normal despite the patients' waking difficulties. Given their similar rules of grammar, both dream and phonetic language modalities could emanate from common sites.
Alprazolam-induced mania: two clinical cases.
Two patients treated with alprazolam had histories suggestive of a bipolar disorder and developed lithium-responsive manic episodes. The authors caution that treatment with alprazolam may be complicated by the induction of mania.
Impairment of environmental effects on brain weight by adrenergic drugs in rats.
Injection of clonidine or methyldopa in rats immediately after daily two-hour exposure to a complex environment (EC) reduced the increase in occipital cortical weight normally associated with such exposure in comparison with animals kept in isolation. Drug injection four hours after EC exposure had no effect. Drug induced suppression of REM sleep during the first four hours after EC exposure was suggested to be the critical variable.
Depression: variability of intrapsychic aspects and of sleep parameters.
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Retroactive impairment of cooperative learning by imipramine and chlordiazepoxide in rats.
Pairs of rats were placed in an apparatus where their sole food source hung over an electrified grid. The current was shut off only while one rat remained on a platform out of reach of the food, thus allowing his partner to eat. Mastery of the process of taking turns at eating required about 10 daily sessions. Injection of imipramine or chlordiazepoxide a few minutes after each feeding session prevented the development of this cooperative behavior. Drug injection 3 hrs after each session had no effect. Suppression of REM sleep during the first 3 hrs after training was considered the most likely mechanism of the drug-induced impairment.
REM sleep and the analytic process: a psychophysiologic bridge.
Recent research on the physiology of REM sleep has supported the hypothesis that it serves processes of psychologic adaptation. This study examines the relationship between physiologic parameters of REM sleep and evidence in analytic material of the need for adaptation. Significant correlations were found between defensive strain before sleep and REM latency, and between change in defensive strain from evening to morning and total REM time.
Clinical measurement in psychoanalysis: an approach.
Measurement of the complex phenomena in psychoanalysis is approached by defining interrelated elements in the analytic situation and specifying the range of their variation in scales which can be both generalized and made specific for an individual patient. Using this approach in transcripts of psychoanalytic sessions, we rate painful emotion, impairment of defensive maneuvers, and activation of threatening conflictual fantasies. This preliminary study involved rating of tape-recorded sessions by psychoanalytically oriented judges. Quantitative estimates appeared to relate in many ways to qualitative fluctuations in the patient's state. Such an approach may be helpful in developing more effective clinical theory about emotions, defensive processes, and transference fantasies.
Happy Christmas... but what about the other 364 days?
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