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DOI: 10.1055/s-2008-1038151
Bipolare affektive Störungen
Teil II: Genetik, Kognition und Therapie
Bipolar Affective DisordersPart II: Genetics, Cognition and Therapy
Publication History
Publication Date:
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
MissingFormLabel
- 2
Craddock N, Forty L.
Genetics of affective (mood) disorders.
Eur J Hum Genet.
2006;
14
660-668
MissingFormLabel
- 3
Kato T.
Molecular genetics of bipolar disorder and depression.
Psychiatry and Clinical Neurosciences.
2007;
61
3-19
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 8
Zobel A, Maier W.
Endophänotypen - ein neues Konzept zur biologischen Charakterisierung psychischer
Störungen.
Der Nervenarzt.
2004;
75
205-214
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 12
Hajek T, Carrey N, Alda M.
Neuroanatomical abnormalities as risk factors for bipolar disorder.
Bipolar Disord.
2005;
7
393-403
MissingFormLabel
- 13
Drevets W C.
Neuroimaging studies of mood disorders.
Biological Psychiatry.
2000;
48
813-829
MissingFormLabel
- 14
Scherk H, Reith W, Falkai P.
Hirnstrukturelle Veränderungen bei bipolaren affektiven Störungen.
Nervenarzt.
2004;
75
861-872
MissingFormLabel
- 15
Savitz J, Solms M, Ramesar R.
Neuropsychological dysfunction in bipolar affective disorder: a critical opinion.
Bipolar Disorders.
2005;
7
216-235
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 21
Murphy F C, Rubinsztein J S, Michael A. et al .
Decision-making cognition in mania and depression.
Psychol Med.
2001;
31
679-693
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 37
American Psychiatric Association .
Practice guideline for the treatment of patients with bipolar disorder (revision).
American Journal of Psychiatry.
2002;
159
1-50
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 48
Krüger S.
Olanzapin in der Behandlung bipolarer affektiver Erkrankungen.
Psychiatr Prax.
2006;
33 Suppl 1
S18-26
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 78 Meyer T, Hautzinger M. Manisch-depressive Störungen. Weinheim: Beltz PVU 2004
MissingFormLabel
- 79 Schaub A, Bernhard B, Gauck L. Kognitiv-psychoedukative Therapie bei bipolaren Erkrankungen. Ein Therapiemanual. Göttingen: Hogrefe 2004
MissingFormLabel
- 80 Wagner P, Bräunig P. Psychoedukation bei bipolaren Störungen. Ein Therapiemanual für Gruppen. Stuttgart: Schattauer 2006
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 83
Brieger P, Becker T.
Spezialisierung in der Gemeindepsychiatrie?.
Die Psychiatrie.
2007;
4
216-220
MissingFormLabel
- 84
Kunze H.
Personenzentrierter Ansatz in der psychiatrischen Versorgung in Deutschland.
Psycho.
1999;
25
728-735
MissingFormLabel
Prof. Dr. Peter Brieger
Bezirkskrankenhaus Kempten
Freudental 1
87435 Kempten
Email: peter.brieger@extern.uni-ulm.de