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Book Review

Nightmares and psychiatric symptoms: A systematic review of longitudinal, experimental, and clinical trial studies


Rek,  Stephanie
IMPRS Translational Psychiatry, Max Planck Institute of Psychiatry, Max Planck Society;

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Sheaves, B., Rek, S., & Freeman, D. (2023). Nightmares and psychiatric symptoms: A systematic review of longitudinal, experimental, and clinical trial studies. CLINICAL PSYCHOLOGY REVIEW, 100: 102241. doi:10.1016/j.cpr.2022.102241.

Cite as: https://hdl.handle.net/21.11116/0000-000D-1BD3-7
Nightmares occur across a wide range of psychiatric disorders, but outside of PTSD presentations are infrequently considered a treatment priority. We aimed to assess evidence for a contributory causal role of nightmares to the occurrence of psychiatric disorders, and vice versa. A systematic review was conducted of longitudinal, exper-imental, and clinical trial studies. Twenty-four longitudinal, sixteen trials, and no experimental studies were identified. Methodological shortcomings were common, especially the use of single-item nightmare assessment. Thirty-five studies assessed the path from nightmares to psychiatric symptoms. Depression (n = 10 studies), PTSD (n = 10) and anxiety (n = 5) were the most commonly assessed outcomes in trials. Most were not designed to assess the effect of nightmare treatment on psychiatric symptoms. Treating nightmares led to moderate re-ductions in PTSD and depression, small to moderate reductions in anxiety, and potentially moderate reductions in paranoia. Nightmares increased the risk of later suicide outcomes (n = 10), but two small pilot trials indicated that treating nightmares might potentially prevent recovery of suicidal ideation. PTSD treatment led to large reductions in trauma-related nightmares (n = 3). The limited literature suggests that treating nightmares may be one route to lessening threat-based disorders in particular, suggestive of a causal relationship. Overall, however, nightmares in most disorders are greatly understudied.