Differenzielle Diagnostik und Pharmakotherapie der juvenilen Manie - eine Übersicht

Zusammenfassung

Manische Störungen und bipolare Psychosen werden mit hoher Wahrscheinlichkeit unter- und fehldiagnostiziert und sind auch wissenschaftlich wesentlich weniger bearbeitet als z. B. schizophrene Psychosen. Dieses Missverhältnis gilt verstärkt für das Jugendalter, da Manien und hypomane Zustände in Praxis und Klinik offensichtlich schwer zu erkennen sind. Aus diesem Grunde sollte sich die fachliche Aufmerksamkeit der Kinder- und Jugendpsychiater vermehrt den bipolaren Störungen zuwenden, da die bisherigen Ergebnisse dafür sprechen, dass unbehandelte uni- und bipolare Störungen zu schwerwiegenden Beeinträchtigungen der Lebensqualität und der psychosozialen Kompetenzen führen können, die qualitativ den psychosozialen Auswirkungen schizophrener Psychosen nicht nachstehen. Diese Auswirkungen können durch eine adäquate Medikation und psychotherapeutische Begleitung wesentlich gebessert werden, sodass auch bei diesen Störungen eine angemessene Früherkennung und Frühbehandlung besonders indiziert sind. Besondere Aufmerksamkeit verdienen die „weicheren” bipolaren Spektrumdiagnosen mit kurzen hypomanen Schwankungen, deren Bedeutung in der KJPP noch nicht genügend gewürdigt wird.

Abstract

Manic disorders and bipolar psychoses have long been underdiagnosed in child and adolescent psychiatry. Scientific research has been rare as well. In particular in adolescence and young adulthood bipolar disorders are not easy to diagnose. Therefore these disorders should be included in differential diagnosis as research from the U. S. shows that there is a significant number of these treatable patients. Being untreated sufficiently major setback in social development and quality of life occur, as severe as in schizophrenia. Adequate medication and psychotherapy in the early phases of these chronic disorders ameliorate the overall prognosis. Special attention should be drawn to hypomanic phases and phenomena as rapid cycling.

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