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Nightmares Are Associated With Future Suicide Attempt and Non-Suicidal Self-Injury in Adolescents.
J Clin Psychiatry. 2019 05 28; 80(4)JC

Abstract

OBJECTIVE

To determine which sleep variables, including sleep duration, sleep quality, insomnia symptoms, and nightmares, were significantly and independently associated with subsequent adolescent suicidal behavior and non-suicidal self-injury (NSSI).

METHODS

A prospective longitudinal study was conducted in Shandong, China. Participants were 7,072 adolescents initially assessed in November and December in 2015 and reassessed 1 year later in 2016. Self-administered structured questionnaires were used to assess suicidal behavior, NSSI, night sleep duration, insomnia symptoms, sleep quality, nightmares, impulsivity, depression, and family demographics. Logistic regression analyses were performed to examine the associations between sleep variables and suicidal behavior and NSSI.

RESULTS

At 1-year follow-up, 190 participants (2.7%) attempted suicide and 621 (8.8%) engaged in NSSI. Insomnia symptoms and frequent nightmares (several times a month) at baseline were significantly associated with subsequent suicide attempt and NSSI 1 year later. After adjustment for covariates including adolescent and family demographics, depression, impulsiveness, and prior suicide attempt/NSSI, frequent nightmares in the past year remained significant for suicide attempt (OR = 1.96; 95% CI, 1.15-3.33) and NSSI (OR = 1.52; 95% CI, 1.10-2.08). With further adjustment for insomnia symptoms, sleep quality, and sleep duration, the associations between frequent nightmares and subsequent suicide attempt and NSSI had almost no change. Insomnia, short sleep duration, and poor sleep quality were not independently associated with subsequent suicide attempt and NSSI.

CONCLUSIONS

Frequent nightmares were independently associated with subsequent suicide attempt and NSSI among adolescents. Assessing and intervening for nightmares may have important implications for early identification of adolescents at risk and prevention of adolescent self-harm and suicide.

Authors+Show Affiliations

School of Public Health, Shandong University, No. 44, Wenhuaxi Rd, Lixia Dist. Jinan 250012, China. kelinresearch6@gmail.com. Shandong University School of Public Health, Jinan, China. South China Normal University School of Psychology, Guangzhou, China.Shandong University School of Public Health, Jinan, China.Yanggu County Center for Disease Control and Prevention, Yanggu, China.Zoucheng City Center for Disease Control and Prevention, Zoucheng, China.Lijin County Center for Disease Control and Prevention, Lijin, China.Shandong University School of Public Health, Jinan, China.Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA.South China Normal University School of Psychology, Guangzhou, China.Shandong University School of Public Health, Jinan, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31141321

Citation

Liu, Xianchen, et al. "Nightmares Are Associated With Future Suicide Attempt and Non-Suicidal Self-Injury in Adolescents." The Journal of Clinical Psychiatry, vol. 80, no. 4, 2019.
Liu X, Liu ZZ, Chen RH, et al. Nightmares Are Associated With Future Suicide Attempt and Non-Suicidal Self-Injury in Adolescents. J Clin Psychiatry. 2019;80(4).
Liu, X., Liu, Z. Z., Chen, R. H., Cheng, X. Z., Bo, Q. G., Wang, Z. Y., Yang, Y., Fan, F., & Jia, C. X. (2019). Nightmares Are Associated With Future Suicide Attempt and Non-Suicidal Self-Injury in Adolescents. The Journal of Clinical Psychiatry, 80(4). https://doi.org/10.4088/JCP.18m12181
Liu X, et al. Nightmares Are Associated With Future Suicide Attempt and Non-Suicidal Self-Injury in Adolescents. J Clin Psychiatry. 2019 05 28;80(4) PubMed PMID: 31141321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nightmares Are Associated With Future Suicide Attempt and Non-Suicidal Self-Injury in Adolescents. AU - Liu,Xianchen, AU - Liu,Zhen-Zhen, AU - Chen,Ren-Hong, AU - Cheng,Xue-Zhi, AU - Bo,Qi-Gui, AU - Wang,Ze-Ying, AU - Yang,Yanyun, AU - Fan,Fang, AU - Jia,Cun-Xian, Y1 - 2019/05/28/ PY - 2018/02/11/received PY - 2019/01/08/accepted PY - 2019/5/30/entrez PY - 2019/5/30/pubmed PY - 2020/4/22/medline JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 80 IS - 4 N2 - OBJECTIVE: To determine which sleep variables, including sleep duration, sleep quality, insomnia symptoms, and nightmares, were significantly and independently associated with subsequent adolescent suicidal behavior and non-suicidal self-injury (NSSI). METHODS: A prospective longitudinal study was conducted in Shandong, China. Participants were 7,072 adolescents initially assessed in November and December in 2015 and reassessed 1 year later in 2016. Self-administered structured questionnaires were used to assess suicidal behavior, NSSI, night sleep duration, insomnia symptoms, sleep quality, nightmares, impulsivity, depression, and family demographics. Logistic regression analyses were performed to examine the associations between sleep variables and suicidal behavior and NSSI. RESULTS: At 1-year follow-up, 190 participants (2.7%) attempted suicide and 621 (8.8%) engaged in NSSI. Insomnia symptoms and frequent nightmares (several times a month) at baseline were significantly associated with subsequent suicide attempt and NSSI 1 year later. After adjustment for covariates including adolescent and family demographics, depression, impulsiveness, and prior suicide attempt/NSSI, frequent nightmares in the past year remained significant for suicide attempt (OR = 1.96; 95% CI, 1.15-3.33) and NSSI (OR = 1.52; 95% CI, 1.10-2.08). With further adjustment for insomnia symptoms, sleep quality, and sleep duration, the associations between frequent nightmares and subsequent suicide attempt and NSSI had almost no change. Insomnia, short sleep duration, and poor sleep quality were not independently associated with subsequent suicide attempt and NSSI. CONCLUSIONS: Frequent nightmares were independently associated with subsequent suicide attempt and NSSI among adolescents. Assessing and intervening for nightmares may have important implications for early identification of adolescents at risk and prevention of adolescent self-harm and suicide. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/31141321/Nightmares_Are_Associated_With_Future_Suicide_Attempt_and_Non_Suicidal_Self_Injury_in_Adolescents_ L2 - http://www.psychiatrist.com/JCP/article/Pages/2019/v80/18m12181.aspx DB - PRIME DP - Unbound Medicine ER -