Associations between frequent nightmares, nightmare distress and depressive symptoms in adolescent psychiatric patients.
Z. Wang, Kai Zhang, Long He, Junyuan Sun, Jintong Liu, Lei Hu
Sleep Medicine March 1, 2023 DOI: 10.1016/j.sleep.2023.03.026 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cross-sectional study Peer reviewed |
|---|---|
| Sample size | 408 |
| Population | Chinese adolescent patients with psychiatric disorders |
| Topics | Dreaming |
| Key findings | Nightmare distress fully mediates the association between frequent nightmares and depressive symptoms in Chinese adolescent psychiatric patients. |
Abstract
Background: Nightmares are common in patients with psychiatric disorders. Patients with psychiatric disorders often experience depressive symptoms. Nightmares have been associated with depressive symptoms among adolescents. Previous studies have explored the mediating role of nightmare distress in the relationship between frequent nightmares and depressive symptoms in the general adolescent population. We aimed to explore the associations between frequent nightmares, nightmare distress, and depressive symptoms in Chinese adolescent patients with psychiatric disorders.
Methods: A total of 408 adolescents participated in this study. A self-administered questionnaire was used to measure nightmare frequency, nightmare distress, depressive symptoms, and covariates. Linear regressions and mediation analyses were performed to examine the associations between nightmare frequency, nightmare distress, and depressive symptoms.
Results: The mean age of participants was 15.31 ± 1.88 years, and 152 (37.3%) were boys. The prevalence of frequent nightmares in adolescent patients with psychosis was 49.3%. Girls reported more frequent nightmares and had significantly higher scores of depressive symptoms and nightmare distress. Patients with frequent nightmares had higher scores of nightmare distress and depressive symptoms. Frequent nightmares and nightmare distress were significantly associated with depressive symptoms. Nightmare distress had a full mediating effect on the correlation between frequent nightmares and depressive symptoms.
Conclusions: In Chinese adolescent patients with psychiatric disorders, frequent nightmares and nightmare distress were associated with depressive symptoms, whereas the association between frequent nightmares and depressive symptoms was mediated by nightmare distress. Interventions for nightmare distress may be more useful in reducing depressive symptoms in adolescent patients with psychiatric disorders.
Comparable studies
Other cross-sectional and survey studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Insomnia Symptoms, Nightmares, and Suicidal Ideation in a College Student Sample Undergraduate students at a large, public university in the southeastern United States | 2011 | Observational cross-sectional survey | n = 583 |
| Prevalence and Correlates of Frequent Nightmares: A Community-Based 2-Phase Study Middle-aged Hong Kong Chinese adults from the community, mean age 40.9 years (SD 5.5,... | 2010 | Cross-sectional survey with subsequent clinical evaluation (two-phase design) | n = 8,558 |
| Factors of home dream recall: a structural equation model Adults (general population sample) | 2003 | Cross-sectional survey with structural equation modeling | n = 444 |
| The Phenomenology of Lucid Dreaming: An Online Survey Respondents to an online survey about lucid dreams | 2014 | Online survey | n = 684 |
| Frequency of Lucid Dreaming in a Representative German Sample Representative sample of German adults | 2011 | Cross-sectional survey | n = 919 |
Citations in the library
Cited by 6
- Nightmares matter: rethinking suicide risk assessment and intervention in depression Sleep April 8, 2026
- The Dream Experience and Its Relationship with Morning Mood in Adolescents Hospitalized after a Suicide Attempt Brain Sciences August 10, 2024
- Seeking help for nightmares in adolescents Somnologie: Schlafforschung und Schlafmedizin December 8, 2023
- Associations between Nightmare Frequency, Nightmare Distress, and Psychopathological Problems among Chinese College Students: a Population-based Survey. Psychiatric Quarterly October 9, 2025
- Nightmare frequency and nightmare distress in psychiatric inpatients. European Archives of Psychiatry and Clinical Neuroscience June 1, 2025
and 1 more in the library
Cites 24
- Nightmare Prevalence, Nightmare Distress, and Self-Reported Psychological Disturbance Sleep 2002
- The relationship of nightmare frequency and nightmare distress to well‐being Journal of Sleep Research May 26, 2004
- Nightmares in Patients with Psychosis: The Relation with Sleep, Psychotic, Affective, and Cognitive Symptoms The Canadian Journal of Psychiatry August 1, 2015
- Longitudinal associations of nightmare frequency and nightmare distress with suicidal behavior in adolescents: mediating role of depressive symptoms Sleep July 2, 2020
- Nightmare in schizophrenic and depressed patients The European Journal of Psychiatry September 1, 2009
and 19 more in the library