Adolescents with major depressive disorder (MDD) experience more frequent nightmares and greater nightmare distress than healthy peers (22.0% vs 6.1% reporting nightmares at least once per week). Among those with suicide risk, over half (51.6%) had frequent nightmares, compared to about a third (30.7%) without suicide risk. Nightmare distress, along with female gender, junior grade, recurrent depressive episodes, and severe depressive symptoms, independently and significantly predicts suicide risk. The findings indicate that nightmare distress is an independent risk factor for suicide in adolescents with MDD, suggesting that addressing nightmares may be important in suicide prevention for this population.
The Nightmare Disorder Index Chinese Version (NDI-CV) shows good psychometric properties for measuring nightmare impact in Chinese adolescents. Among 6,014 adolescents who completed the NDI-CV along with measures of nightmare distress, sleep quality, insomnia, daytime sleepiness, anxiety, and depression, the questionnaire demonstrated strong internal consistency with a Cronbach's α coefficient of 0.876. Test-retest reliability was assessed in 423 adolescents after a 2-week interval, with a correlation coefficient confidence interval of 0.675-0.977. The findings indicate the NDI-CV is a valid and reliable instrument for assessing nightmare disorder in this population.