Trajectory of adolescents' nightmares in relation to depression and post-traumatic stress disorder in young adulthood: a 10-year cohort of Chinese Wenchuan earthquake survivors.

Purpose: This study examined the longitudinal trajectories of adolescent survivors' nightmares after the Wenchuan earthquake and tested whether specific trajectory memberships of nightmares could predict depression and post-traumatic stress disorder (PTSD) in the 10 years after earthquake.

Methods: 610 adolescents exposed to the Wenchuan earthquake were surveyed on nightmares at 18 months (T), 24 months (T), and 30 months (T) after the earthquake. Depression and PTSD were assessed at baseline (T) and 10 years (T) after the catastrophe. Data were analyzed using linear regression analysis.

Results: The prevalence rates of frequent nightmares at three time points were 9.8%, 11.5%, and 9.3%, respectively. Five different trajectories of nightmares were identified: resistance (77.0%), recover (8.4%), delayed-dysfunction (7.9%), chronic-dysfunction (1.1%), and relapsing/remitting (5.6%). Additionally, we found that participants in relapsing/remitting, chronic or delayed dysfunction trajectories compared with those in the resistant group were more likely to experience depression and PTSD in young adulthood after adjusting for a wide range of covariates.

Conclusions: Nightmares had heterogeneity after a catastrophic earthquake. Timely assessment and targeted interventions on specific nightmares are necessary for reducing the incidence of psychiatric disorders.