RSS-Feed abonnieren
DOI: 10.1055/s-2008-1038151
Bipolare affektive Störungen
Teil II: Genetik, Kognition und Therapie
Bipolar Affective DisordersPart II: Genetics, Cognition and Therapy
Publikationsverlauf
Publikationsdatum:
28. April 2008 (online)

Lernziele
In unserem ersten Artikel zum Thema hatten wir Diagnostik, Epidemiologie und Verlauf bipolarer Erkrankungen dargestellt [1]. Der nachfolgende zweite Teil widmet sich Genetik, Kognition und Therapie. Ziel dieses Artikels ist es, neben neueren Erkenntnissen zur Neurobiologie differenzielle und evidenzbasierte Strategien der Therapie bipolar affektiver Störungen aufzuzeigen. Dabei wird neben der Psychopharmakotherapie auch der Aspekt der Psychotherapie und Psychoedukation sowie der gemeindepsychiatrischen Versorgung diskutiert.
Literatur
- 1
Brieger P.
Bipolare affektive Störungen. Teil I: Diagnostik, Epidemiologie und Verlauf.
Fortschr Neurol Psychiatr.
2007;
75
673-684
Reference Ris Wihthout Link
- 2
Craddock N, Forty L.
Genetics of affective (mood) disorders.
Eur J Hum Genet.
2006;
14
660-668
Reference Ris Wihthout Link
- 3
Kato T.
Molecular genetics of bipolar disorder and depression.
Psychiatry and Clinical Neurosciences.
2007;
61
3-19
Reference Ris Wihthout Link
- 4
Schulze T G, Hedeker D, Zandi P, Rietschel M, McMahon F J.
What Is Familial About Familial Bipolar Disorder? Resemblance Among Relatives Across
a Broad Spectrum of Phenotypic Characteristics.
Archives of General Psychiatry.
2006;
63
1368-1376
Reference Ris Wihthout Link
- 5
Lerer B, Segman R H.
Pharmacogenetics of antipsychotic therapy: pivotal research issues and the prospects
for clinical implementation.
Dialogues Clin Neurosci.
2006;
8
85-94
Reference Ris Wihthout Link
- 6
Alda M, Grof P, Rouleau G A, Turecki G, Young L T.
Investigating responders to lithium prophylaxis as a strategy for mapping susceptibility
genes for bipolar disorder.
Prog Neuropsychopharmacol Biol Psychiatry.
2005;
29
1038-1045
Reference Ris Wihthout Link
- 7
Einat H, Yuan P, Szabo S T, Dogra S, Manji H K.
Protein kinase C inhibition by tamoxifen antagonizes manic-like behavior in rats:
implications for the development of novel therapeutics for bipolar disorder.
Neuropsychobiology.
2007;
55
123-131
Reference Ris Wihthout Link
- 8
Zobel A, Maier W.
Endophänotypen - ein neues Konzept zur biologischen Charakterisierung psychischer
Störungen.
Der Nervenarzt.
2004;
75
205-214
Reference Ris Wihthout Link
- 9
Akiskal H S, Brieger P, Mundt C, Angst J, Marneros A.
Temperament und affektive Störungen. Die TEMPS-A-Skala als Konvergenz europäischer
und US-amerikanischer Konzepte.
Nervenarzt.
2002;
73
262-271
Reference Ris Wihthout Link
- 10
Chiaroni P, Hantouche E G, Gouvernet J, Azorin J M, Akiskal H S.
The cyclothymic temperament in healthy controls and familially at risk individuals
for mood disorder: endophenotype for genetic studies?.
J Affect Disord.
2005;
85
135-145
Reference Ris Wihthout Link
- 11
Hallam K T, Olver J S, Chambers V. et al .
The heritability of melatonin secretion and sensitivity to bright nocturnal light
in twins.
Psychoneuroendocrinology.
2006;
31
867-875
Reference Ris Wihthout Link
- 12
Hajek T, Carrey N, Alda M.
Neuroanatomical abnormalities as risk factors for bipolar disorder.
Bipolar Disord.
2005;
7
393-403
Reference Ris Wihthout Link
- 13
Drevets W C.
Neuroimaging studies of mood disorders.
Biological Psychiatry.
2000;
48
813-829
Reference Ris Wihthout Link
- 14
Scherk H, Reith W, Falkai P.
Hirnstrukturelle Veränderungen bei bipolaren affektiven Störungen.
Nervenarzt.
2004;
75
861-872
Reference Ris Wihthout Link
- 15
Savitz J, Solms M, Ramesar R.
Neuropsychological dysfunction in bipolar affective disorder: a critical opinion.
Bipolar Disorders.
2005;
7
216-235
Reference Ris Wihthout Link
- 16
Strakowski S M, Delbello M P, Adler C M.
The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings.
Mol Psychiatry.
2005;
10
105-116
Reference Ris Wihthout Link
- 17
Basso M R, Lowery N, Neel J, Purdie R, Bornstein R A.
Neuropsychological impairment among manic, depressed, and mixed-episode inpatients
with bipolar disorder.
Neuropsychology.
2002;
16
84-91
Reference Ris Wihthout Link
- 18
Olley A, Malhi G S, Batchelor J. et al .
Executive functioning and theory of mind in euthymic bipolar disorder.
Bipolar Disorders.
2005;
7
43-52
Reference Ris Wihthout Link
- 19
Martinez-Aran A, Vieta E, Colom F. et al .
Neuropsychological performance in depressed and euthymic bipolar patients.
Neuropsychobiology.
2002;
46 Suppl 1
16-21
Reference Ris Wihthout Link
- 20
Clark L, Iversen S D, Goodwin G M.
A neuropsychological investigation of prefrontal cortex involvement in acute mania.
American Journal of Psychiatry.
2001;
158
1605-1611
Reference Ris Wihthout Link
- 21
Murphy F C, Rubinsztein J S, Michael A. et al .
Decision-making cognition in mania and depression.
Psychol Med.
2001;
31
679-693
Reference Ris Wihthout Link
- 22
Malhi G S, Ivanovski B, Hadzi-Pavlovic D. et al .
Neuropsychological deficits and functional impairment in bipolar depression, hypomania
and euthymia.
Bipolar Disord.
2007;
9
114-125
Reference Ris Wihthout Link
- 23
Martinez-Aran A, Vieta E, Reinares M. et al .
Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar
disorder.
American Journal of Psychiatry.
2004;
161
262-270
Reference Ris Wihthout Link
- 24
Nehra R, Chakrabarti S, Pradhan B K, Khehra N.
Comparison of cognitive functions between first- and multi-episode bipolar affective
disorders.
J Affect Disord.
2006;
93
185-192
Reference Ris Wihthout Link
- 25
Robinson L J, Ferrier I N.
Evolution of cognitive impairment in bipolar disorder: a systematic review of cross-sectional
evidence.
Bipolar Disord.
2006;
8
103-116
Reference Ris Wihthout Link
- 26
Dittmann S, Seemuller F, Schwarz M J. et al .
Association of cognitive deficits with elevated homocysteine levels in euthymic bipolar
patients and its impact on psychosocial functioning: preliminary results.
Bipolar Disord.
2007;
9
63-70
Reference Ris Wihthout Link
- 27
Altshuler L L, Ventura J, Gorp W van G. et al .
Neurocognitive function in clinically stable men with bipolar I disorder or schizophrenia
and normal control subjects.
Biological Psychiatry.
2004;
56
560-569
Reference Ris Wihthout Link
- 28
Torrent C, Martinez-Aran A, Amann B. et al .
Cognitive impairment in schizoaffective disorder: a comparison with non-psychotic
bipolar and healthy subjects.
Acta Psychiatrica Scandinavica.
2007;
116
453-460
Reference Ris Wihthout Link
- 29
Borkowska A, Rybakowski J K.
Neuropsychological frontal lobe tests indicate that bipolar depressed patients are
more impaired than unipolar.
Bipolar Disorders.
2001;
3
88-94
Reference Ris Wihthout Link
- 30
Martinez-Aran A, Vieta E, Torrent C. et al .
Functional outcome in bipolar disorder: the role of clinical and cognitive factors.
Bipolar Disord.
2007;
9
103-113
Reference Ris Wihthout Link
- 31
Dickerson F B, Boronow J J, Stallings C R. et al .
Association between cognitive functioning and employment status of persons with bipolar
disorder.
Psychiatr Serv.
2004;
55
54-58
Reference Ris Wihthout Link
- 32
Laes J R, Sponheim S R.
Does cognition predict community function only in schizophrenia?: A study of schizophrenia
patients, bipolar affective disorder patients, and community control subjects.
Schizophr Res.
2006;
84
121-131
Reference Ris Wihthout Link
- 33
Tohen M, Zarate Jr C A, Hennen J. et al .
The McLean-Harvard First-Episode Mania Study: Prediction of Recovery and First Recurrence.
Am J Psychiatry.
2003;
160
2099-2107
Reference Ris Wihthout Link
- 34
Brieger P, Rottig S, Rottig D, Marneros A, Priebe S.
Dimensions underlying outcome criteria in bipolar I disorder.
Journal of Affective Disorders.
2007;
99
1-7
Reference Ris Wihthout Link
- 35
Tohen M, Bowden C L, Calabrese J R. et al .
Influence of sub-syndromal symptoms after remission from manic or mixed episodes.
Br J Psychiatry.
2006;
189
515-519
Reference Ris Wihthout Link
- 36
Fountoulakis K N, Vieta E, Sanchez-Moreno J. et al .
Treatment guidelines for bipolar disorder: a critical review.
J Affect Disord.
2005;
86
1-10
Reference Ris Wihthout Link
- 37
American Psychiatric Association .
Practice guideline for the treatment of patients with bipolar disorder (revision).
American Journal of Psychiatry.
2002;
159
1-50
Reference Ris Wihthout Link
- 38
Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines
Team for Bipolar Disorder .
Australian and New Zealand clinical practice guidelines for the treatment of bipolar
disorder.
Aust N Z J Psychiatry.
2004;
38
280-305
Reference Ris Wihthout Link
- 39
Yatham L N, Kennedy S H, O'Donovan C. et al .
Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management
of patients with bipolar disorder: update 2007.
Bipolar Disord.
2006;
8
721-739
Reference Ris Wihthout Link
- 40 National Institute for Health and Clinical Excellence .NICE clinical guideline 38: Bipolar disorder: the management of bipolar disorder in
adults, children and adolescents, in primary and secondary care. London: National Institute for Health and Clinical Excellence 2006
Reference Ris Wihthout Link
- 41
Goodwin F K.
The biology of recurrence: new directions for the pharmacologic bridge.
J Clin Psychiatry.
1989;
50 Suppl
40-44; discussion 45 - 47
Reference Ris Wihthout Link
- 42
Findling R L, Frazier T W, Youngstrom E A. et al .
Double-blind, placebo-controlled trial of divalproex monotherapy in the treatment
of symptomatic youth at high risk for developing bipolar disorder.
J Clin Psychiatry.
2007;
68
781-788
Reference Ris Wihthout Link
- 43
Judd L L, Akiskal H S, Schettler P J. et al .
Psychosocial disability in the course of bipolar I and II disorders: a prospective,
comparative, longitudinal study.
Arch Gen Psychiatry.
2005;
62
1322-1330
Reference Ris Wihthout Link
- 44
Gijsman H J, Geddes J R, Rendell J M, Nolen W A, Goodwin G M.
Antidepressants for Bipolar Depression: A Systematic Review of Randomized, Controlled
Trials.
Am J Psychiatry.
2004;
161
1537-1547
Reference Ris Wihthout Link
- 45
Ketter T A, Calabrese J R.
Stabilization of mood from below versus above baseline in bipolar disorder: a new
nomenclature.
J Clin Psychiatry.
2002;
63
146-151
Reference Ris Wihthout Link
- 46
Keck Jr P E, Calabrese J R, McQuade R D. et al .
A randomized, double-blind, placebo-controlled 26-week trial of aripiprazole in recently
manic patients with bipolar I disorder.
J Clin Psychiatry.
2006;
67
626-637
Reference Ris Wihthout Link
- 47
Keck Jr P E, Calabrese J R, McIntyre R S. et al .
Aripiprazole monotherapy for maintenance therapy in bipolar I disorder: a 100-week,
double-blind study versus placebo.
J Clin Psychiatry.
2007;
68
1480-1491
Reference Ris Wihthout Link
- 48
Krüger S.
Olanzapin in der Behandlung bipolarer affektiver Erkrankungen.
Psychiatr Prax.
2006;
33 Suppl 1
S18-26
Reference Ris Wihthout Link
- 49
Geddes J R, Burgess S, Hawton K, Jamison K, Goodwin G M.
Long-Term Lithium Therapy for Bipolar Disorder: Systematic Review and Meta-Analysis
of Randomized Controlled Trials.
Am J Psychiatry.
2004;
161
217-222
Reference Ris Wihthout Link
- 50
Goodwin G M, Bowden C L, Calabrese J R. et al .
A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium
maintenance in bipolar I disorder.
J Clin Psychiatry.
2004;
65
432-441
Reference Ris Wihthout Link
- 51
Ghaemi S N, Gilmer W S, Goldberg J F. et al .
Divalproex in the treatment of acute bipolar depression: a preliminary double-blind,
randomized, placebo-controlled pilot study.
J Clin Psychiatry.
2007;
68
1840-1844
Reference Ris Wihthout Link
- 52
Bowden C L, Calabrese J R, McElroy S L. et al .
A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment
of outpatients with bipolar I disorder. Divalproex Maintenance Study Group.
Arch Gen Psychiatry.
2000;
57
481-489
Reference Ris Wihthout Link
- 53
Gyulai L, Bowden C L, McElroy S L. et al .
Maintenance efficacy of divalproex in the prevention of bipolar depression.
Neuropsychopharmacology.
2003;
28
1374-1382
Reference Ris Wihthout Link
- 54
Dando T M, Keating G M.
Quetiapine: a review of its use in acute mania and depression associated with bipolar
disorder.
Drugs.
2005;
65
2533-2551
Reference Ris Wihthout Link
- 55 Severus W E, Kleindienst N, Seemuller F. et al .What is the optimal serum lithium level in the long-term treatment of bipolar disorder?
A review. Bipolar Disord im Druck
Reference Ris Wihthout Link
- 56
Zarate Jr C A, Tohen M.
Double-blind comparison of the continued use of antipsychotic treatment versus its
discontinuation in remitted manic patients.
Am J Psychiatry.
2004;
161
169-171
Reference Ris Wihthout Link
- 57
Okuma T, Inanaga K, Otsuki S. et al .
A preliminary double-blind study on the efficacy of carbamazepine in prophylaxis of
manic-depressive illness.
Psychopharmacology (Berl).
1981;
73
95-96
Reference Ris Wihthout Link
- 58
Greil W, Ludwig-Mayerhofer W, Erazo N. et al .
Lithium versus carbamazepine in the maintenance treatment of bipolar disorders - a
randomised study.
J Affect Disord.
1997;
43
151-161
Reference Ris Wihthout Link
- 59
Calabrese J R, Keck Jr P E, Macfadden W. et al .
A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment
of bipolar I or II depression.
Am J Psychiatry.
2005;
162
1351-1360
Reference Ris Wihthout Link
- 60
Tohen M, Vieta E, Calabrese J. et al .
Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar
I depression.
Arch Gen Psychiatry.
2003;
60
1079-1088
Reference Ris Wihthout Link
- 61
Sachs G S, Nierenberg A A, Calabrese J R. et al .
Effectiveness of adjunctive antidepressant treatment for bipolar depression.
N Engl J Med.
2007;
356
1711-1722
Reference Ris Wihthout Link
- 62
Calabrese J R, Bowden C L, Sachs G S. et al .
A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients
with bipolar I depression. Lamictal 602 Study Group.
J Clin Psychiatry.
1999;
60
79-88
Reference Ris Wihthout Link
- 63
Brown E B, McElroy S L, Keck Jr P E. et al .
A 7-week, randomized, double-blind trial of olanzapine/fluoxetine combination versus
lamotrigine in the treatment of bipolar I depression.
J Clin Psychiatry.
2006;
67
1025-1033
Reference Ris Wihthout Link
- 64
Vieta E, Calabrese J R, Goikolea J M, Raines S, Macfadden W.
Quetiapine monotherapy in the treatment of patients with bipolar I or II depression
and a rapid-cycling disease course: a randomized, double-blind, placebo-controlled
study.
Bipolar Disord.
2007;
9
413-425
Reference Ris Wihthout Link
- 65
Zarate Jr C A, Payne J L, Singh J. et al .
Pramipexole for bipolar II depression: a placebo-controlled proof of concept study.
Biol Psychiatry.
2004;
56
54-60
Reference Ris Wihthout Link
- 66
Goldberg J F, Burdick K E, Endick C J.
Preliminary randomized, double-blind, placebo-controlled trial of pramipexole added
to mood stabilizers for treatment-resistant bipolar depression.
Am J Psychiatry.
2004;
161
564-566
Reference Ris Wihthout Link
- 67
Frangou S, Lewis M, McCrone P.
Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind
placebo-controlled study.
Br J Psychiatry.
2006;
188
46-50
Reference Ris Wihthout Link
- 68
Frye M A, Grunze H, Suppes T. et al .
A placebo-controlled evaluation of adjunctive modafinil in the treatment of bipolar
depression.
Am J Psychiatry.
2007;
164
1242-1249
Reference Ris Wihthout Link
- 69
Bschor T, Lewitzka U, Sasse J. et al .
Lithium augmentation in treatment-resistant depression: clinical evidence, serotonergic
and endocrine mechanisms.
Pharmacopsychiatry.
2003;
36 Suppl 3
S230-234
Reference Ris Wihthout Link
- 70
Nolen W A, Kupka R W, Hellemann G. et al .
Tranylcypromine vs. lamotrigine in the treatment of refractory bipolar depression:
a failed but clinically useful study.
Acta Psychiatr Scand.
2007;
115
360-365
Reference Ris Wihthout Link
- 71
Gajwani P, Kemp D E, Muzina D J. et al .
Acute treatment of mania: an update on new medications.
Curr Psychiatry Rep.
2006;
8
504-509
Reference Ris Wihthout Link
- 72
Scherk H, Pajonk F G, Leucht S.
Second-generation antipsychotic agents in the treatment of acute mania: a systematic
review and meta-analysis of randomized controlled trials.
Arch Gen Psychiatry.
2007;
64
442-455
Reference Ris Wihthout Link
- 73
Licht R W.
Limitations in randomised controlled trials evaluating drug effects in mania.
Eur Arch Psychiatry Clin Neurosci.
2001;
251 Suppl 2
II66-71
Reference Ris Wihthout Link
- 74
Colom F, Vieta E, Tacchi M J, Sanchez-Moreno J, Scott J.
Identifying and improving non-adherence in bipolar disorders.
Bipolar Disord.
2005;
7 Suppl 5
24-31
Reference Ris Wihthout Link
- 75 Meyer T D, Hautzinger M. Psychoedukation und Psychotherapie. In: DGBS (ed). Weißbuch Bipolare Störungen in Deutschland Stand des Wissens - Defizite
- Was ist zu tun? 2. überarbeitete Auflage ed. Hamburg: ConferencePoint Verlag 2006: 325-298
Reference Ris Wihthout Link
- 76
Scott J, Colom F, Vieta E.
A meta-analysis of relapse rates with adjunctive psychological therapies compared
to usual psychiatric treatment for bipolar disorders.
Int J Neuropsychopharmacol.
2007;
10
123-129
Reference Ris Wihthout Link
- 77
Colom F, Vieta E, Martinez-Aran A. et al .
A randomized trial on the efficacy of group psychoeducation in the prophylaxis of
recurrences in bipolar patients whose disease is in remission.
Arch Gen Psychiatry.
2003;
60
402-407
Reference Ris Wihthout Link
- 78 Meyer T, Hautzinger M. Manisch-depressive Störungen. Weinheim: Beltz PVU 2004
Reference Ris Wihthout Link
- 79 Schaub A, Bernhard B, Gauck L. Kognitiv-psychoedukative Therapie bei bipolaren Erkrankungen. Ein Therapiemanual. Göttingen: Hogrefe 2004
Reference Ris Wihthout Link
- 80 Wagner P, Bräunig P. Psychoedukation bei bipolaren Störungen. Ein Therapiemanual für Gruppen. Stuttgart: Schattauer 2006
Reference Ris Wihthout Link
- 81
Scott J, Paykel E, Morriss R. et al .
Cognitive-behavioural therapy for severe and recurrent bipolar disorders: Randomised
controlled trial.
Br J Psychiatry.
2006;
188
313-320
Reference Ris Wihthout Link
- 82
Miklowitz D J, Otto M W, Frank E. et al .
Psychosocial Treatments for Bipolar Depression: A 1-Year Randomized Trial From the
Systematic Treatment Enhancement Program.
Arch Gen Psychiatry.
2007;
64
419-426
Reference Ris Wihthout Link
- 83
Brieger P, Becker T.
Spezialisierung in der Gemeindepsychiatrie?.
Die Psychiatrie.
2007;
4
216-220
Reference Ris Wihthout Link
- 84
Kunze H.
Personenzentrierter Ansatz in der psychiatrischen Versorgung in Deutschland.
Psycho.
1999;
25
728-735
Reference Ris Wihthout Link
Prof. Dr. Peter Brieger
Bezirkskrankenhaus Kempten
Freudental 1
87435 Kempten
eMail: peter.brieger@extern.uni-ulm.de