NIGHTMARES AND PSYCHOTIC DECOMPENSATION - A CASE-STUDY

THERE have been numerous reports in the literature on the descriptive similarities between a severe nightmare and an acute psychotic episode . Nightmares may be a prelude to psychotic decompensation, and it has been suggested that frequent lifelong nightmares may even be diagnosti c of an underlying vulnerability to psychosis. In this report, we pres ent a case study of a 40-year old female experiencing chronic paranoid schizophrenia, whose two witnessed psychotic relapses in the hospital were immediately preceded by intense and vivid nightmare attacks. Sig nificantly, the content of these nocturnal dreams was thematically con sistent with her waking hallucinations, suggesting a direct continuity between these experiences. We propose that further systematic study o f the dreams and nightmares of individuals diagnosed with schizophreni a may be particularly useful in understanding their phenomenological e xperience.