Nightmare Prevalence in an Outpatient Pediatric Psychiatry Population: A Brief Report

Treatable pernicious nightmares are underreported in clinical and community samples and are often unrecognized by health-care providers. Frequent childhood nightmares double the odds of youth suicidal ideation and quadruple the odds of a youth suicide attempt. However, if detected, nightmares are treatable with cognitive behavioral or pharmacological interventions. Currently, rates of nightmares and nightmare disorder in outpatient pediatric psychiatry populations are unknown. We report findings of nightmare screening conducted at an outpatient pediatric psychiatry facility. A total of 806 children were seen at the clinic over the period of the study; 782 parents of patients aged 3 to 17 received paper-and-pencil screeners. Of those, 678 (86.7%) completed the screeners, and 276 (40.7%) were positive for nightmares, with most children remembering their nightmares. A total of 89 (32.2%) "always" remembered their nightmares, and 165 (59.8%) "sometimes" remembered the nightmares. In addition, 155 (56.2%) had nightmares the week prior, and of those, 59 (38.1%) "always" remembered the nightmares and 82 (52.9%) "sometimes" remembered. Aggregated electronic medical record data found that of the 806 patients seen during the study period, 12 (0.01%) had been diagnosed with nightmare disorder, 129 (16%) had been diagnosed with posttraumatic stress disorder, and 24 (0.03%) had acute stress disorder. Although electronic medical record data showed that few children with chronic nightmares were identified by clinicians, many families were interested in treatment. We join with researchers of adult populations in calling for routine screening of nightmares.