Content warnings: Depression, suicide

  • From the 1145 articles screened, 24 were retained, including 9 studies with patients with mood disorders, 11 studies with patients with psychotic disorders and 4 studies with either psychotic or mood disorders. Nightmares were more frequent in individuals with mood or psychotic disorders than in healthy controls (more than two-fold). Patients with frequent nightmares had higher suicidality scores and had more frequently a history of suicide attempt. The distress associated with nightmares, rather than the frequency of nightmares, was associated with the severity of the psychiatric disorder.
  • One study found that patients with MDD [major depressive disorder] experienced nightmares more than twofold than healthy controls (mean of 44.6 nightmares per year in patients with MDD, versus 18 nightmares per year in healthy controls; the prevalence of nightmares was 16.7% and 4.9%, respectively) [25].
  • Thünker et al. [33] tested the effectiveness of standardized nightmare therapy based on image rehearsal therapy (IRT), in MDD patients suffering from nightmares, and showed a decrease in the nightmare frequency. Woo et al. [35] found an improvement for nightmares in MDD patients after four sessions of eye movement desensitization and reprocessing (EMDR).
  • We used a prospective cohort study, based on 40,902 participants with a mean follow-up duration of 19.0 years.
  • The occurrence of nightmares was highly correlated to other sleep-related difficulties and measures of depression. […] Nightmare frequency was highly correlated with self-reported depressive and anxiety symptoms, sleep duration, and insomnia.
  • we found no evidence suggesting that nightmares influence the incidence of suicide.
  • Twenty-one clinical studies and 25 case reports were eligible for review and document a clear AD effect on dreaming.
  • Vivid dreaming and nightmares have been described during treatment and withdrawal of serotonin reuptake inhibitors, not only in depression
  • Independently of the substance classes, there is a potential to develop nightmares in the acute phase both during implementation and even more so after stopping of an AD treatment. Administration of SSRIs seems to have a higher potential to cause nightmares than intake of tricyclic ADs, which might be explained by the activating properties of SSRIs.