Download PDF
Fortschr Neurol Psychiatr 2015; 83(02): 74-82
DOI: 10.1055/s-0034-1398934
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Differenzialdiagnostik der Bipolaren Störung: historische und klinische Implikationen und Perspektiven

Differential Diagnosis of Bipolar Disorder: Historical and Clinical Implications and Perspectives
F. M. Schmidt
1   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig
,
H. Steinberg
2   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Archiv für Leipziger Psychiatriegeschichte
,
H. Himmerich
1   Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig
› Author Affiliations
Further Information

Publication History

12 September 2014

15 January 2015

Publication Date:
27 February 2015 (online)

    Permissions and Reprints

Zusammenfassung

Im DSM-5 wird die Bipolare Störung (BS) nicht länger zusammen mit der unipolaren Depression als affektive Störung konzeptualisiert, sondern als Brücke zwischen Schizophrenien und depressiven Störungen angesehen. In dieser nosologischen Einordnung spiegelt sich der medizinhistorische Kontext des 19. Jahrhunderts wider. Neben unipolarer Depression und Schizophrenie weisen differenzialdiagnostisch auch die schizoaffektive Störung, die emotional-instabile Persönlichkeitsstörung und das Aufmerksamkeitsdefizit-/Hyperaktivitätssyndrom (ADHS) Überlappungen mit der BS auf. Überschneidungen zeigen außerdem somatische Erkrankungen wie die Multiple Sklerose, das Cushing-Syndrom und die Syphilis und iatrogen bedingte affektive Syndrome.

Abstract

In DSM-5, bipolar disorder (BS) is no longer conceptualised as a pure mood disorder together with unipolar depression, but as a bridge between schizophrenia and depressive disorders. This nosological classification is founded on the historical context of the 19th century. In addition to unipolar depression and schizophrenia, schizoaffective disorder, borderline personality disorder and attention-deficit hyperactivity disorder (ADHD) overlap with BS symptomatology. Overlap also exists with somatic diseases such as multiple sclerosis, Cushing’s syndrome and syphilis as well as iatrogenic affective syndromes.

Schlüsselwörter

Bipolare Störung - Differenzialdiagnosen - Komorbiditäten - Kraepelin - sekundäre Manie

Key words

bipolar disorder - differential diagnosis - comorbidities - Kraepelin - secondary mania
 

  • Literatur

  • 1 Dilling H, Mombour W, Schmidt MH. Internationale Klassifikation psychischer Störungen: ICD-10 Kapitel V (F) Klinisch-diagnostische Leitlinien. 6. vollst. überarb. Aufl. Bern: Hans Huber; 2008
    Google Scholar
  • 2 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition: DSM-IV. Washington, DC: American Psychiatric Association; 2000
    Google Scholar
  • 3 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Edition: DSM-5. Washington, DC: American Psychiatric Association; 2013
    Google Scholar
  • 4 Karam EG, Sampson N, Itani L et al. Under-reporting bipolar disorder in large-scale epidemiologic studies. J Affect Disord 2014; 159: 147-154
    CrossrefPubMedGoogle Scholar
  • 5 Mitchell PB. Bipolar disorder: the shift to overdiagnosis. Can J Psychiatry 2012; 57: 659-665
    PubMedGoogle Scholar
  • 6 Akiskal HS. The emergence of the bipolar spectrum: validation along clinical-epidemiologic and familial-genetic lines. Psychopharmacol Bull 2007; 40: 99-115
    PubMedGoogle Scholar
  • 7 Ng B, Camacho A, Lara DR et al. A case series on the hypothesized connection between dementia and bipolar spectrum disorders: bipolar type VI?. J Affect Disord 2008; 107: 307-315
    CrossrefPubMedGoogle Scholar
  • 8 Pfennig A, Bschor T, Falkai P et al. The diagnosis and treatment of bipolar disorder: recommendations from the current s3 guideline. Dtsch Arztebl Int 2013; 110: 92-100
    PubMedGoogle Scholar
  • 9 Marneros A. Origin and development of bipolar mixed states. J Affect Disord 2001; 67: 229-240
    CrossrefPubMedGoogle Scholar
  • 10 Griesinger W. Die Pathologie und Therapie der psychischen Krankheiten für Aerzte und Studierende. Stuttgart: Krabbe; 1845
    Google Scholar
  • 11 Heinroth JCA. Lehrbuch der Störungen des Seelenlebens oder der Seelenstörungen und ihrer Behandlung. Leipzig: Vogel; 1818
    Google Scholar
  • 12 Pichot P. The birth of the bipolar disorder. Eur Psychiat 1995; 10: 1-10
    CrossrefPubMedGoogle Scholar
  • 13 Falret JP. Marche de la folie (suite). Gaz Hop 1851; 24: 18-19
    PubMedGoogle Scholar
  • 14 Falret JP. Mémoire sur la folie circulaire, forme de la maladie mentale caractérisée par la reproduction successive et régulière de l’état maniaque, de l’état mélancolique, et d’un intervalle lucide plus ou moins prolongé. Bull Acad Imp Med 1854; 19/4a: 382-400
    PubMedGoogle Scholar
  • 15 Baillarger J. De la folie à double forme. Ann Med Psychol 1854; 6: 369-391
    PubMedGoogle Scholar
  • 16 Kraepelin E. Psychiatrie. 8. Aufl. Leipzig: Barth; 1913
    Google Scholar
  • 17 Kraepelin E. Zur Diagnose und Prognose der Dementia praecox. Allg Z Psychiat 1899; 56: 254-259
    PubMedGoogle Scholar
  • 18 Bleuler E. Dementia Praecox oder Gruppe der Schizophrenien. Leipzig: Deuticke; 1911
    Google Scholar
  • 19 Angst J. Zur Ätiologie und Nosologie endogener depressiver Psychosen. Berlin: Springer; 1966
    CrossrefGoogle Scholar
  • 20 Perris C. A study of bipolar and unipolar recurrent depressive psychoses. Acta Psychiat Scand 1966; 194 (Suppl. 41) 7-189
    PubMedGoogle Scholar
  • 21 Marneros A, Roettig S, Roettig D et al. The longitudinal polymorphism of bipolar I disorders and its theoretical implications. J Affect Disord 2008; 107: 117-126
    CrossrefPubMedGoogle Scholar
  • 22 Doherty JL, Owen MJ. Genomic insights into the overlap between psychiatric disorders: implications for research and clinical practice. Genome Med 2014; 6: 29
    CrossrefPubMedGoogle Scholar
  • 23 Gatt JM, Burton KL, Williams LM et al. Specific and common genes implicated across major mental disorders: A review of meta-analysis studies. J Psychiatr Res 2014; 60C: 1-13
    PubMedGoogle Scholar
  • 24 Zobel A, Maier W. Endophänotypen – ein neues Konzept zur biologischen Charakterisierung psychischer Störungen. Nervenarzt 2004; 75: 205-214
    CrossrefPubMedGoogle Scholar
  • 25 Thaker GK. Neurophysiological endophenotypes across bipolar and schizophrenia psychosis. Schizophr Bull 2008; 34: 760-773
    PubMedGoogle Scholar
  • 26 Arnone D, Cavanagh J, Gerber D et al. Magnetic resonance imaging studies in bipolar disorder and schizophrenia: meta-analysis. Br J Psychiatry 2009; 195: 194-201
    CrossrefPubMedGoogle Scholar
  • 27 Ranft K, Dobrowolny H, Krell D et al. Evidence for structural abnormalities of the human habenular complex in affective disorders but not in schizophrenia. Psychol Med 2010; 40: 557-567
    CrossrefPubMedGoogle Scholar
  • 28 Nardi AE, Nascimento I, Freire RC et al. Demographic and clinical features of schizoaffective (schizobipolar) disorder – a 5-year retrospective study. Support for a bipolar spectrum disorder. J Affect Disord 2005; 89: 201-206
    CrossrefPubMedGoogle Scholar
  • 29 Malaspina D, Owen MJ, Heckers S et al. Schizoaffective Disorder in the DSM-5. Schizophr Res 2013; 150: 21-25
    CrossrefPubMedGoogle Scholar
  • 30 Beesdo K, Höfler M, Leibenluft E et al. Mood episodes and mood disorders: patterns of incidence and conversion in the first three decades of life. Bipolar Disord 2009; 11: 637-649
    CrossrefPubMedGoogle Scholar
  • 31 Angst J, Sellaro R, Stassen HH et al. Diagnostic conversion from depression to bipolar disorders: results of a long-term prospective study of hospital admissions. J Affect Disord 2005; 84: 149-157
    CrossrefPubMedGoogle Scholar
  • 32 Correa R, Akiskal H, Gilmer W et al. Is unrecognized bipolar disorder a frequent contributor to apparent treatment resistant depression?. J Affect Disord 2010; 127: 10-18
    CrossrefPubMedGoogle Scholar
  • 33 Goodwin GM, Anderson I, Arango C et al. ECNP consensus meeting. Bipolar depression Nice, March 2007. Eur Neuropsychopharmacol 2007; 18: 535-549
    PubMedGoogle Scholar
  • 34 Fink M, Bolwig TG, Parker G et al. Melancholia: restoration in psychiatric classification recommended. Acta Psychiatr Scand 2007; 115: 89-92
    CrossrefPubMedGoogle Scholar
  • 35 Mitchell PB, Goodwin GM, Johnson GF et al. Diagnostic guidelines for bipolar depression: a probabilistic approach. Bipolar Disord 2008; 10: 144-152
    CrossrefPubMedGoogle Scholar
  • 36 Strauss M, Sander C, Mergl R et al. Onset of Depression Inventory (ODI)-Assessment of the speed of onset of depressive episodes. J Affect Disord 2012; 142: 156-160
    CrossrefPubMedGoogle Scholar
  • 37 Merikangas KR, Akiskal HS, Angst J et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 2007; 64: 543-552
    Google Scholar
  • 38 Zepf FD. Attention deficit-hyperactivity disorder and early-onset bipolar disorder: two facets of one entity?. Dialogues Clin Neurosci 2009; 11: 63-72
    PubMedGoogle Scholar
  • 39 Schmidt FM, Schönherr J, Sander C et al. Applying EEG-based vigilance measurement in a case of adult attention deficit hyperactivity disorder (ADHD). Int J Neuropsychopharmacol 2013; 16: 1169-71
    CrossrefPubMedGoogle Scholar
  • 40 Franke B, Neale BM, Faraone SV. Genome-wide association studies in ADHD. Hum Genet 2009; 126: 13-50
    CrossrefPubMedGoogle Scholar
  • 41 Hensch T, Himmerich H, Hegerl U. ADHD and bipolar disorder: common causes common cure?. J Atten Disord 2011; 15: 99-100
    CrossrefPubMedGoogle Scholar
  • 42 Sander C, Arns M, Olbrich S et al. EEG-vigilance and response to stimulants in paediatric patients with attention deficit/hyperactivity disorder. Clin Neurophysiol 2010; 121: 1511-1518
    CrossrefPubMedGoogle Scholar
  • 43 Kluge M, Hegerl U, Sander C et al. Methylphenidate in mania project (MEMAP): study protocol of an international randomised double-blind placebo-controlled study on the initial treatment of acute mania with methylphenidate. BMC Psychiatry 2013; 13: 71
    CrossrefPubMedGoogle Scholar
  • 44 Schoenknecht P, Olbrich S, Sander C et al. Treatment of acute mania with modafinil monotherapy. Biol Psychiatry 2010; 67: e55-e77
    CrossrefPubMedGoogle Scholar
  • 45 Paris J, Gunderson J, Weinberg I. The interface between borderline personality disorder and bipolar spectrum disorders. Compr Psychiatry 2007; 48: 145-154
    CrossrefPubMedGoogle Scholar
  • 46 Perugi G, Fornaro M, Akiskal HS. Are atypical depression, borderline personality disorder and bipolar II disorder overlapping manifestations of a common cyclothymic diathesis?. World Psychiatry 2011; 10: 45-51
    PubMedGoogle Scholar
  • 47 Antoniadis D, Samakouri M, Livaditis M. The association of bipolar spectrum disorders and borderline personality disorder. Psychiatr Q 2012; 83: 449-465
    CrossrefPubMedGoogle Scholar
  • 48 Steinberg H, Himmerich H. Emil Kraepelin’s habilitation and his thesis: a pioneer work for modern systematic reviews, psychoimmunological research and categories of psychiatric diseases. World J Biol Psychiatry 2013; 14: 248-257
    CrossrefPubMedGoogle Scholar
  • 49 Himmerich H, Steinberg H. Hormonelle Krankheits- und Therapiekonzepte in der Psychiatrie. Fortschr Neurol Psychiatr 2011; 79: 384-394
    Article in Thieme ConnectPubMedGoogle Scholar
  • 50 Haskett RF. Diagnostic categorization of psychiatric disturbance in Cushing's syndrome. Am J Psychiatry 1985; 142: 911-916
    CrossrefPubMedGoogle Scholar
  • 51 Himmerich H, Fulda S, Linseisen J et al. Depression, comorbidities and the TNF-alpha system. Eur Psychiatry 2008; 23: 421-429
    CrossrefPubMedGoogle Scholar
  • 52 Brietzke E, Stertz L, Fernandes BS et al. Comparison of cytokine levels in depressed, manic and euthymic patients with bipolar disorder. J Affect Disord 2009; 116: 214-217
    CrossrefPubMedGoogle Scholar
  • 53 Schmidt FM, Lichtblau N, Minkwitz J et al. Cytokine levels in depressed and non-depressed subjects, and masking effects of obesity. J Psychiatr Res 2014; 55: 29-34
    CrossrefPubMedGoogle Scholar
  • 54 Munzer A, Sack U, Mergl R et al. Impact of antidepressants on cytokine production of depressed patients in vitro. Toxins 2013; 5: 2227-2240
    CrossrefPubMedGoogle Scholar
  • 55 Himmerich H, Bartsch S, Hamer H et al. Impact of mood stabilizers and antiepileptic drugs on cytokine production in-vitro. J Psychiatr Res 2013; 47: 1751-1759
    CrossrefPubMedGoogle Scholar
  • 56 Lichtblau N, Schmidt FM, Schumann R et al. Cytokines as biomarkers in depressive disorder: current standing and prospects. Int Rev Psychiatry 2013; 25: 592-603
    CrossrefPubMedGoogle Scholar
  • 57 Marrie RA, Horwitz R, Cutter G et al. The burden of mental comorbidity in multiple sclerosis: frequent, underdiagnosed, and undertreated. Mult Scler 2009; 15: 385-392
    CrossrefPubMedGoogle Scholar
  • 58 Lau C, Ettinger AB, Hamberger S et al. Do mood instability symptoms in epilepsy represent formal bipolar disorder?. Epilepsia 2012; 53: e37-e40
    CrossrefPubMedGoogle Scholar
  • 59 Adelöw C, Andersson T, Ahlbom A et al. Hospitalization for psychiatric disorders before and after onset of unprovoked seizures/epilepsy. Neurology 2007; 78: 396-401
    PubMedGoogle Scholar
  • 60 Morgan VA, Croft ML, Valuri GM et al. Intellectual disability and other neuropsychiatric outcomes in high-risk children of mothers with schizophrenia, bipolar disorder and unipolar major depression. Br J Psychiatry 2012; 200: 282-289
    CrossrefPubMedGoogle Scholar
  • 61 Bender RE, Alloy LB. Life stress and kindling in bipolar disorder: review of the evidence and integration with emerging biopsychosocial theories. Clin Psychol Rev 2011; 31: 383-398
    CrossrefPubMedGoogle Scholar
  • 62 Barbosa IG, Vale TC, de Macedo DL et al. Neurosyphilis presenting as mania. Bipolar Disord 2012; 14: 309-312
    CrossrefPubMedGoogle Scholar
  • 63 Gijsman HJ, Geddes JR, Rendell JM et al. Antidepressants for bipolar depression: a systematic review of randomized, controlled trials. Am J Psychiatr 2004; 161: 1537-1547
    CrossrefPubMedGoogle Scholar
  • 64 Leverich GS, Altshuler LL, Frye MA et al. Risk of switch in mood polarity to hypomania or mania in patients with bipolar depression during acute and continuation trials of venlafaxine, sertraline, and bupropion as adjuncts to mood stabilizers. Am J Psychiatry 2006; 163: 232-239
    CrossrefPubMedGoogle Scholar
  • 65 Chan PK, Lam RW, Perry KF. Mania precipitated by light therapy for patients with SAD. J Clin Psychiatry 1994; 55: 454
    PubMedGoogle Scholar
  • 66 Bai YM, Su TP, Li CT et al. Comparison of pro-inflammatory cytokines among patients with bipolar disorder and unipolar depression and normal controls. Bipolar Disord DOI: 10.1111/bdi.12259.
    PubMedGoogle Scholar
  • 67 Brambilla P, Bellani M, Isola M et al. Increased M1/decreased M2 signature and signs of Th1 / Th2 shift in chronic patients with bipolar disorder, but not in those with schizophrenia. Transl Psychiatry DOI: 10.1038/tp.2014.46.
    PubMedGoogle Scholar
  • 68 Petersein C, Sack U, Mergl R et al. Impact of lithium alone and in combination with antidepressants on cytokine production in vitro. J Neural Transm DOI: 10.1007/s00702-014-1328-6.
    PubMedGoogle Scholar