Nightmares and Psychotic Decompensation: A Case Study

• Published in: Psychiatry (Washington, D.C.) Vol. 61; no. 3; pp. 217 - 222
• Main Authors: Levin, Ross, Daly, Rebecca Stiritz
• Format: Journal Article
• Language: English
• Published: United States Routledge 01.10.1998; William Alanson White Psychiatric Foundation; Taylor & Francis Ltd
• Subjects: Adult; Dreams; Dreams - psychology; Female; Humans; Nightmares; Psychology; Psychotic Disorders - complications; Psychotic Disorders - physiopathology; Psychotic Disorders - psychology; Recurrence; Schizophrenia; Schizophrenia, Paranoid - complications; Schizophrenia, Paranoid - physiopathology; Schizophrenia, Paranoid - psychology; Sleep Wake Disorders - complications; Sleep Wake Disorders - psychology; Women
• ISSN: 0033-2747; 1943-281X
• DOI: 10.1080/00332747.1998.11024833

There have been numerous reports in the literature on the descriptive similarities between a severe nightmare and an acute psychotic episode. Nightmares may be a prelude to psychotic decompensation, and it has been suggested that frequent lifelong nightmares may even be diagnostic of an underlying vulnerability to psychosis. In this report, we present a case study of a 40-year old female experiencing chronic paranoid schizophrenia, whose two witnessed psychotic relapses in the hospital were immediately preceded by intense and vivid nightmare attacks. Significantly, the content of these nocturnal dreams was thematically consistent with her waking hallucinations, suggesting a direct continuity between these experiences. We propose that further systematic study of the dreams and nightmares of individuals diagnosed with schizophrenia may be particularly useful in understanding their phenomenological experience.