When altered dreams herald a suicidal crisis

This could be a new tool in predicting suicidal risks and thus reducing the burden of voluntary death, which, although decreasing, affects approximately 700,000 people worldwide each year. Recent work by a French team has shown that changes in dreams occur in 80% of people hospitalized for a suicidal crisis (defined by suicidal thoughts or attempts), with progression in the preceding months.

Psychiatrist and sleep specialist Pierre Geoffroy (Hospital Bichat-Claude-Bernard, AP-HP, GHU Paris) and his colleagues interviewed forty people about their nights in a psychiatric emergency department due to a suicidal crisis, they report in January-February. 2023 edition Journal of Clinical Psychiatry.

The researchers were particularly interested in three types of “events”: bad dreams (unpleasant content), nightmares (bad dreams that wake you up), and nightmares with a suicidal scenario. Results: Of the 31 women and 9 men studied, with an average age of 29, only 8 (20%) had no change in their dreams before the onset of the suicidal crisis. And of the 32 altered dream triggers, or 80% of the workforce, 27 (67.5%) reported bad dreams, 21 (52.5%) nightmares, and 9 (22.5%) nightmares with a suicidal scenario. One in six (17.5%) had a change in the content of all three types of dreams. Pierre Geoffroy and his colleagues specified that two groups – without dreams or without altered dreams – were compared according to age, sex, physical activity, socioeconomic conditions. In addition, the majority of patients suffered from anxiety disorders or depression and poor quality sleep – and 60% of them had actual insomnia.

Understanding intimate mechanisms

Although links between nightmares and suicide attempts have already been suggested by several studies, the originality of the work published Journal of Clinical Psychiatry There is a trajectory of changing the dream. Thus, French researchers observe that bad dreams appear on average one hundred and eleven days before the onset of a suicidal crisis, nightmares ninety-seven days before and twenty-five days before a suicidal scenario.

“Of course, bad dreams or nightmares are not pathological in themselves” – Pierre Geoffroy, Psychiatrist

This progression to three stages, which respectively start four months before a hospitalization crisis, should be a warning signal to key stakeholders and their doctors, believes Professor Geoffroy. “Of course, bad dreams or nightmares are not pathological in themselves.he recalls. It is their appearance and recurrence in the context of depression that should warn of the intensity of the experiences in these altered dreams and their repercussions during the day. Some of these patients literally feel cornered by suicidal scenarios. »