Glucksman Myron L
Clinical Professor of Psychiatry, New York Medical College; Supervising and Training Analyst, The Psychoanalytic Institute, New York Medical College, Valhalla, NY.
Psychodyn Psychiatry. 2014 Dec;42(4):657-70. doi: 10.1521/pdps.2014.42.4.657.
The prediction of suicidal intent remains a clinical problem. This presentation illustrates that a distinction may be made between the manifest dream reports of patients who are potentially or acutely suicidal and those who are not. A review of the literature reveals that the manifest dream reports of clinically depressed, non-suicidal individuals differ from those who are depressed and acutely suicidal. The former contain themes of loss, disappointment, rejection, helplessness, hopelessness, failure, and death. The latter contain themes of dying, death, destruction, and violence directed toward the dreamer or others, as well as hopelessness and helplessness. The author collected manifest dream reports from three clinically depressed, non-suicidal patients and three clinically depressed, potentially or acutely suicidal patients. There are apparent differences between the themes of manifest dream reports in the clinically depressed, non-suicidal patients and the clinically depressed, potentially or acutely suicidal patients. The former contain themes of death, loss, rejection, vulnerability, hopelessness, and helplessness. The latter contain themes of active harm or violence (specifically toward the dreamer), dying or being dead, aloneness, vulnerability, hopelessness, and helplessness. Clinical cases and corresponding manifest dream reports are presented. Although this is a preliminary study, it is possible that manifest dream content may be used as one of the predictors of suicidality, in conjunction with latent dream content, diagnosis, life circumstance, and clinical status.
自杀意图的预测仍然是一个临床难题。本报告表明，在有潜在自杀倾向或急性自杀倾向的患者与无此类倾向的患者的显性梦境报告之间可以做出区分。对文献的回顾显示，临床上抑郁但无自杀倾向的个体的显性梦境报告与抑郁且有急性自杀倾向的个体不同。前者包含失落、失望、被拒绝、无助、绝望、失败和死亡等主题。后者包含死亡、毁灭以及针对做梦者或他人的暴力等主题，还有绝望和无助。作者收集了三名临床上抑郁但无自杀倾向的患者以及三名临床上抑郁、有潜在或急性自杀倾向的患者的显性梦境报告。临床上抑郁但无自杀倾向的患者与临床上抑郁、有潜在或急性自杀倾向的患者的显性梦境报告主题之间存在明显差异。前者包含死亡、失落、被拒绝、脆弱、绝望和无助等主题。后者包含主动伤害或暴力（特别是针对做梦者）、死亡或已死亡、孤独、脆弱、绝望和无助等主题。文中呈现了临床病例及相应的显性梦境报告。尽管这是一项初步研究，但显性梦境内容有可能与隐性梦境内容、诊断、生活状况及临床状态一起，被用作自杀倾向的预测指标之一。
