Original scientific paper

NIGHTMARES AND SUICIDE: PREDICTING RISK IN DEPRESSION

Petra Marinova ; Department of Psychiatry, Medical University Sofia & Second Psychiatric Clinic, University Hospital for Neurology and Psychiatry “St. Naum”, Sofia, Bulgaria
Ivan Koychev ; Department of Psychosis Studies, Institute of Psychiatry, London, UK
Lili Laleva ; Department of Neurosurgery, Tokuda Hospital Sofia, Sofia, Bulgaria
Lyudmila Kancheva ; Gastroenterology Clinic, University Hospital “St. Ivan Rilski”, Sofia, Bulgaria
Milen Tsvetkov ; Urology Clinic, University Hospital “N.I. Pirogov”, Sofia, Bulgaria
Radoslav Bilyukov ; Internal Medicine Propedeutics Department, Medical University Sofia & Pulmonology Clinic, University Hospital “Aleksandrovska”, Sofia, Bulgaria
Diana Vandeva ; Clinic for Metabolic-Endocrine Diseases and Dietetics, University Hospital “Tsaritsa Yoanna ISUL”, Sofia, Bulgaria
Alan Felthouse ; Department of Neurology and Psychiatry, St. Louis University School of Medicine, St. Louis, USA
Georgi Koychev ; Private Psychiatric Outpatient Clinic, Sofia, Bulgaria

Abstract

Background: There is growing evidence of an association of a number of subjective and objective sleep parameters (especially
nightmares) and elevated suicidal risk in different clinical populations as well as in the general populations.
Subjects and methods: This is a cross-sectional naturalistic study of 52 inpatients (28 females and 24 males, aged from 24 to 75
years) meeting criteria for a current depressive episode within Recurrent Depressive Disorder (RDD) or Bipolar Disorder (BD)
according to ICD-10. All patients were evaluated with the Hamilton Depression Rating Scale (HDRS), followed by a direct interview
about their dreams’ content and emotional charge, as well as about suicidal thoughts and plans or previous attempts.
Results: Patients with RDD suffered significantly more frequently from nightmares than those with BD, p<0.05. Within the RDD
group, experiencing nightmares was associated with significantly higher scores on the HDRS suicide risk item (2.36 vs 1.00), higher
frequency of suicide attempts (35% vs 6%), and lower likelihood for lack of detectable suicide risk (21% vs 81%), p<0.05. These
differences were not explained by significant difference in the severity of depressive symptoms (28.00 vs 24.75, p=0.16). We were
unable to detect such differences in the bipolar subgroup. No gender influences on the association of nightmares and suicidal risk
were observed.
Conclusions: Depressed patients suffering from nightmares showed significantly higher suicide risk. Depression appeared to be
a stronger risk factor for suicidal behavior when accompanied with nightmares. This was only valid for unipolar depression, while
the results concerning bipolar depression were inconclusive.

Keywords

depression – nightmares – suicide - suicide prevention

Hrčak ID:

162067

URI

https://hrcak.srce.hr/162067

Publication date:

17.6.2014.

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