Imagery rehearsal therapy in addition to treatment as usual for patients with diverse psychiatric diagnoses suffering from nightmares: a randomized controlled trial.
Annette van Schagen, Jaap Lancee, Izaäk W De Groot, Victor I. Spoormaker, Jan Van den Bout
The Journal of Clinical Psychiatry September 1, 2015 DOI: 10.4088/jcp.14m09216 (opens in new tab) via PubMed
Summary
AI-generated from the abstractImagery rehearsal therapy (IRT) reduces nightmare frequency, nightmare distress, and general psychiatric symptoms in patients with a range of psychiatric disorders. In a trial of 90 patients, those who received six individual IRT sessions added to their usual treatment showed moderate improvements compared with those receiving treatment as usual alone. The benefits were largely sustained three months later. IRT involves patients changing the script of a nightmare into a new dream and practicing it during the day.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 90 |
| Population | Patients with psychiatric disorders (DSM-IV-TR) |
| Intervention | Imagery rehearsal therapy |
| Duration | 6 individual sessions, 3-month follow-up |
| Registration | NCT00291031 |
| Key finding | Imagery rehearsal therapy moderately reduced nightmare frequency, distress, and psychopathology compared with treatment as usual, with effects largely sustained at 3-month follow-up. |
Abstract
Nightmares are associated with psychopathology and daily distress. They are highly prevalent in a psychiatric population (30%). Currently, imagery rehearsal therapy (IRT) is the treatment of choice for nightmares. With IRT, the script of the nightmare is changed into a new dream, which is imagined during the day. However, the effects of IRT in a psychiatric population remain unknown. The aim of this study was to determine the effectiveness of IRT in a heterogeneous psychiatric population. Between January 2006 and July 2010, 90 patients with psychiatric disorders (DSM-IV-TR) were randomized to IRT or treatment-as-usual conditions. IRT consisted of 6 individual sessions added to the treatment as usual. Nightmare frequency was assessed using daily nightmare logs and the Nightmare Frequency Questionnaire. Nightmare distress was assessed using the Nightmare Distress Questionnaire and the Nightmare Effects Survey. General psychiatric symptoms were assessed using the Symptom Checklist-90 and a PTSD symptom questionnaire. Assessments were administered at the start of the trial, after the IRT and at follow-up 3 months later. IRT showed a moderate effect (Cohen d = 0.5-0.7, P < .05) on nightmare frequency, nightmare distress, and psychopathology measures compared with treatment as usual. These effects were largely sustained at the 3-month follow-up (Cohen d = 0.4-0.6, P < .10). IRT is an effective treatment for nightmares among patients with comorbid psychiatric disorders and can be employed in addition to the on-going treatment. ClinicalTrials.gov identifier: NCT00291031.