Nightmares, suicide attempts, and melancholic features in patients with unipolar major depression.

OBJECTIVES: Recently, there has been a growing interest in the relationship between sleep disturbances and suicidality in major depression. Sleep disturbances are one of the 'modifiable risks' for suicide in major depression. The present study examines whether there is a relationship among nightmares, suicide attempts, and melancholic features in unipolar major depressed patients. METHODS: One hundred (49 males and 51 females) depressed patients with melancholic features and 49 (23 males and 26 females) patients without melancholic features were included in the study. All patients were classified as those who attempted suicide at least once during current depressive episode and as those who never attempted. RESULTS: Melancholic attempters had higher rates of nightmares, middle, and terminal insomnia than melancholic non-attempters. There was no significant difference between non-melancholic patients with and without suicidal attempts in terms of the frequency of all types of insomnia and nightmares. LIMITATIONS: This study does not have polysomnographic records for sleep variables. CONCLUSIONS: Feeling worse in the morning than later in the day may be related to the intervening dream content and affect and predict suicidal tendency. Melancholia may be associated with increased risk of suicide attempts due to repetitive and frightening dreams.

Nightmares and terminal insomnia in depressed patients with and without melancholic features.

To investigate the relationship between nightmares and melancholic features (MF) in depression, we compared depressed patients with and without MF (n=82 and n=75, respectively) regarding the presence of nightmares. Nightmares were significantly more frequent in patients with MF. Depressed mood in the morning may be related to negative dream content.

Nightmares and serum cholesterol level: a preliminary report.

OBJECTIVE: To examine whether there is a relation between nightmares and serum lipid levels. METHODS: Fifteen subjects who met DSM-IV criteria for the diagnosis of nightmare disorder and 15 healthy control subjects participated in the study. We used an enzymatic colorimetric method for cholesterol and triglyceride determination. We measured high-density lipoprotien (HDL) cholesterol using the direct HDL-cholesterol method. Low-density lipoprotein (LDL) was calculated according to the Friedewald formula. RESULTS: Patients with nightmare disorder had lower serum triglyceride, lower total cholesterol, and lower LDL levels than healthy control subjects. CONCLUSION: These findings suggest that nightmares are associated with low serum lipid levels.

Serum lipid concentrations in obsessive-compulsive disorder patients with and without panic attacks.

OBJECTIVE: To examine serum lipid levels in patients with obsessive-compulsive disorder (OCD) and to test whether panic symptoms affect lipid concentrations in OCD patients. METHODS: We assessed 33 OCD patients and 33 healthy control subjects matched for sex and age. RESULTS: OCD patients had higher low-density lipoprotein, very-low-density lipoprotein, and tryglyceride levels, but lower high-density lipoprotein levels, than normal control subjects. We also found that only OCD patients with panic attacks had higher serum lipid concentrations, compared with normal control subjects. Serum lipid levels of pure OCD patients did not differ from control values. CONCLUSION: These findings suggest that high serum lipid concentrations are related to panic anxiety rather than other symptoms of the illness.