Nightmares: prevalence and treatment in secondary mental healthcare

Nightmares are highly prevalent in the general population (2-8%) and are associated with mental problems. As a result, nightmares are likely to be more prevalent among patients in secondary mental healthcare. They can be treated with 'imagery rehearsal therapy' (IRT). With IRT the scenario of a recurring nightmare is changed, after which the 'new dream' is imagined several times a day. AIM: To assess the prevalence of nightmares and their associated problems in secondary mental healthcare and to find out whether IRT is also effective in patients with diverse mental disorders. METHOD: A patient group was asked about their nightmares at the start of their treatment in secondary mental healthcare. Another group of patients with nightmares received six sessions with IRT in addition to their conventional treatment and the results were compared to a group of patients that had only received conventional treatment. RESULTS: 30% patients had severe nightmares and had higher mental distress than patients without nightmares. With IRT there was a reduction in both the number and intensity of nightmares and the psychiatric symptoms. CONCLUSION: Nightmares are an underestimated problem for patients with diverse psychiatric disorders in secondary mental healthcare. However, nightmares can also be treated effectively with IRT in this population.