Are delusional contents replayed during dreams?

In acutely psychotic patients with a single fixed delusion, fragments of that delusional thought appear in their dreams, suggesting continuity between waking delusions and dream content. Ten patients reported dreams during an acute psychotic break. Sixteen judges, with varying familiarity with each patient's delusion, tried to group the dreams by matching them to the correct patient. Most judges performed only slightly above chance, and no significant differences emerged between groups with different levels of acquaintance. Scoring dreams for specific delusional themes revealed continuity for Grandiosity and Religion. The findings indicate that some delusional contents recur within patients' dreams, possibly reflecting ongoing memory consolidation processes relevant to delusion formation.

Study at a glance

Abstract

The relationship between dream content and waking life experiences remains difficult to decipher. However, some neurobiological findings suggest that dreaming can, at least in part, be considered epiphenomenal to ongoing memory consolidation processes in sleep. Both abnormalities in sleep architecture and impairment in memory consolidation mechanisms are thought to be involved in the development of psychosis. The objective of this study was to assess the continuity between delusional contents and dreams in acutely psychotic patients. Ten patients with a single fixed and recurring delusional content were asked to report their dreams during an acute psychotic break. Sixteen judges with four different levels of acquaintance to the specific content of the patients' delusions were asked to group the dreams, expecting that fragments of the delusional thought would guide the task. A mathematical index (f,t) was developed in order to compare correct groupings between the four groups of judges. Most judges grouped the dreams slightly above chance level and no relevant differences could be found between the four groups [F(3,12)=1.297; p=n.s.]. Scoring of dreams for specific delusional themes suggested a continuity in terms of dream and waking mentation for two contents (Grandiosity and Religion). These findings seem to suggest that at least some delusional contents recur within patients' dreams. Future studies will need to determine whether such continuity reflects ongoing consolidation processes that are relevant to current theories of delusion formation and stabilization.