Nightmares As Predictor of Suicidal Symptoms

Self-reported nightmares among patients seeking emergency psychiatric evaluation appear to be an excellent forecaster of elevated suicidal symptoms.

Results indicate that severe nightmares were independently associated with elevated suicidal symptoms after accounting for the influence of depression, whereas symptoms of insomnia were not.

These findings suggest that nightmares stand alone as a suicide risk factor.

The sample included 82 men and women between the ages of 18 and 66, who were in a community mental health hospital admissions unit awaiting an emergency psychiatric evaluation. Evaluations determined eligibility for crisis stabilization inpatient admittance.

Patients’ nightmares, insomnia, depression and suicidal tendencies were assessed through several questionnaires, including the Disturbing Dreams and Nightmare Severity Index, Insomnia Severity Index (ISI), Beck Depression Inventory (BDI), and the Beck Scale for Suicide Ideation (BSS).

According to principal investigator Rebecca Bernert, doctoral candidate in clinical psychology at Florida State University, findings of the study emphasize the need for a more thorough assessment ofsleep among acutely ill patients, as it may be an important opportunity for intervention.

“Sleep disturbances, especially nightmares, appear to be an acute warning sign and risk factor for suicide,” said Bernert.

“Given that poor sleep is amenable to treatment, and less stigmatized than depression and suicide, our findings could impact standardized suicide risk assessment and prevention efforts.”

The study states that sleep complaints are now listed among the top 10 warning signs of suicide by the Substance Abuse and Mental Health Services Administration (SAMHSA).