Graduate School of Human Sciences, Waseda University, Tokorozawa City, Saitama, Japan.
Palliat Support Care. 2010 Mar;8(1):95-8. doi: 10.1017/S1478951509990757. Epub 2010 Feb 18.
The death of a person is a stressful event. Such stress affects the physical and psychological well-being of the bereaved. As an associated mental disorder, major depressive disorder (MDD) is common. Some dream of the deceased, and these dreams are called bereavement dreams. Some MDD patients also experience dreams. These two types of dreams are sometimes difficult to differentiate. The dream of the bereaved might be only a bereavement-related dream, yet it might be a symptom of MDD. Herein, we report one patient who had distressing dreams after the death of her mother.
A 63-year-old woman was referred for psychiatric consultation because of generalized fatigue and insomnia. Questioning her about recent events, she said that her mother had died of colonic carcinoma 5 months previously. Two months after the death, she suddenly started dreaming of her mother, getting angry with her almost every night. Generalized fatigue, insomnia, and distressing dreams appeared simultaneously. The dream caused much distress, making her afraid to fall asleep.
Her psychiatric features fulfilled the DSM-IV-TR criteria for MDD, single episode. The death of her mother was considered to be one of the causes of MDD. She was administered 25 mg/day of sertraline hydrochloride. After that, her symptoms gradually disappeared, and the frequency of distressing dreams was reduced. Five months later, physical and psychiatric symptoms of MDD were completely resolved. Subsequently, she has not suffered from any distressing dreams of her mother.
This case indicates that dreams experienced after the death of a loved one should not be regarded simply as bereavement dreams. Some of the dreams may be symptoms of MDD. If the dreams are the symptoms of MDD, antidepressant treatment as well as psychotherapy may be useful. Therefore, we should avoid regarding symptoms of MDD as reactions to bereavement.
人的死亡是一个应激事件。这种压力会影响到丧亲者的身心健康。作为一种相关的精神障碍，重度抑郁症（MDD）很常见。有些人会梦到逝者，这些梦被称为丧亲之梦。一些 MDD 患者也会做梦。这两种梦有时很难区分。丧亲者的梦可能只是与丧亲有关的梦，但也可能是 MDD 的症状。在这里，我们报告了一位在母亲去世后做噩梦的患者。
一位 63 岁的女性因全身疲劳和失眠被转介到精神科咨询。询问她最近的情况时，她说她的母亲 5 个月前死于结肠癌。在母亲去世后两个月，她突然开始梦到母亲，几乎每晚都对她生气。全身疲劳、失眠和做噩梦同时出现。这个梦让她非常痛苦，使她害怕入睡。
她的精神特征符合 DSM-IV-TR 中 MDD 单发性发作的标准。母亲的去世被认为是 MDD 的一个原因。她开始服用 25 毫克/天的盐酸舍曲林。之后，她的症状逐渐消失，做噩梦的频率也降低了。五个月后，MDD 的躯体和精神症状完全缓解。此后，她再也没有做过关于母亲的噩梦。
这个病例表明，在亲人去世后经历的梦境不应简单地视为丧亲之梦。其中一些梦可能是 MDD 的症状。如果这些梦是 MDD 的症状，抗抑郁治疗和心理治疗可能会有帮助。因此，我们不应将 MDD 的症状视为对丧亲的反应。
