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DOI: 10.1055/s-2005-915327
Differenzielle Diagnostik und Pharmakotherapie der juvenilen Manie - eine Übersicht
Differential Diagnosis and Pharmacotherapy of Juvenile Mania - A ReviewPublication History
Publication Date:
01 March 2006 (online)
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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.
Literatur
- 1 Braun-Scharm H, Leeners T. Juvenile Manien - eine Literaturübersicht. Forum Kinder- und Jugendpsychiatrie. 2005; 3 23-55
- 2 Carlson G A, Kashani J H. What is new in bipolar and major depressive disorder in children and adolescents. Child Adolesc Psychiat Clin North Am. 2002; 11 XV-XXII
- 3 Conus P, McGorry P D. First-episode mania: a neglected priority for early intervention. Aust N Z J Psychiatry. 2002; 36 158-172
- 4 Judd L L, Akiskal H S, Schettler P J, Endicott J, Maser J, Solomon D A, Leon A C, Rice J A, Keller M B. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry. 2002; 59 530-537
- 5 Akiskal H S. Validating „hard” and „soft” phenotypes within the bipolar spectrum: continuity or discontinuity?. J Affect Disord. 2003; 73 1-5
- 6 Nissen G. Affektive Psychosen in der Adoleszenz. Nervenarzt. 1975; 46 302-307
- 7 Findling R L, Gracious B L, McNamara N K, Youngstrom E A, Demeter C A, Branicky L A, Calabrese J R. Rapid, continuous cycling and psychiatric co-morbidity in pediatric bipolar I disorder. Bipol Disord. 2001; 3 202-210
- 8 Geller B, Luby J. Child and adolescent bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 1997; 36/9 1168-1176
- 9 Jones P M, Berney T P. Early onset rapid cycling bipolar affective disorder. J Child Psychol Psychiatry. 1987; 28/5 731-738
- 10 Coryell W, Leon A C, Turvey C, Akiskal H S, Mueller T, Endicott J. The significance of psychotic features inmanic episodes: a report from the NIMH collaborative study. J Affect Disord. 2001; 67 79-88
- 11 Shiratsuchi T, Takahashi N, Suzuki T, Abe K. Depressive episodes of bipolar disorder in early teenage years: changes with increasing age and the significance of IQ. J Affect Disord. 2000; 58 161-166
- 12 Pavuluri M N, Birmaher B, Naylor M W. Pediatric bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2005; 44 (9) 846-871
- 13 Todd R D, Botteron K N. Etiology and genetics of early-onset mood disorders. Child Adolesc Clin North Am. 2002; 11 499-518
- 14 Bieling P J, MacQueen G M, Marriot M J, Robb J C, Begin H, Joffe R T, Young L Z. Longitudinal outcome in patients with bipolar disorder assessed by life-charting is influenced by DSM-IV personality disorder symptoms. Bipol Disord. 2003; 5 14-21
- 15 Birmaher B, Kennah A, Brent D, Ehmann M, Bridge J, Axelson D. Is bipolar disorder specifically associated with panic disorder in youths?. J Clin Psychiatry. 2002; 63/5 414-419
- 16 Brieger P, Ehrt U, Marneros A. Frequency of comorbid personality disorders in bipolar and unipolar affective disorders. Comprehens Psychiatry. 2003; 44/1 28-34
- 17 Frank E, Cyranowski J M, Rucci P, Shear K, Fagiolini A, Thase M E, Cassano G B, Grochocinski V J, Kostelnik B, Kupfer D J. Clinical significance of lifetime panic spectrum symptoms in the treatment of patients with bipolar I disorder. Arch Gen Psychiatry. 2002; 59 905-911
- 18 Johnson J G, Cohen P, Brook J S. Associations between bipolar disorder and other psychiatric disorders during adolescence and early adulthood: a community based longitudinal investigation. Am J Psychiatry. 2000; 157 1679-1681
- 19 Kay J H, Altshuler L L, Ventura J, Mintz J. Impact of axis II comorbidity on the course of bipolar illness in men: a retrospective chart review. Bipol Disord. 2002; 4 237-242
- 20 Masi G, Toni C T, Perugi G, Mucci M, Millepiedi S, Akiskal H S. Anxiety disorders in children and adolescents with bipolar disorder: a neglected comorbidity. Can J Psychiatry. 2001; 46 797-802
- 21 Wozniak J, Biederman J, Faraone S V, Blier H, Monuteaux M C. Heterogeneity of childhood conduct disorder: further evidence of a subtype of conduct disorder linked to bipolar disorder. J Affect Dis. 2001; 64 121-131
- 22 Biederman J, Wozniak J, Kiely K, Ablon S, Faraone S, Mick E, Mundy E, Kraus I. CBCL clinical scales discriminate prepubertal children with structured interview-derived diagnosis of mania from those with ADHD. J Am Acad Child Adolesc Psychiatry. 1995; 34/4 464-471
- 23 Biederman J, Mick E, Faraone S V, Spencer T, Wilens T E, Wozniak J. Pediatric mania: a developmental subtype of bipolar disorder?. Biol Psychiatry. 2000; 48 458-466
- 24 Faraone S V, Biederman J, Mennin D, Wozniak J, Spencer T. Attention-deficit hyperactivity disorder with bipolar disorder: a familial subtype?. J Am Acad Child Adolesc Psychiatry. 1997a; 36/10 1378-1387
- 25 Faraone S V, Biederman J, Wozniak J, Mundy E, Mennin D, O'Donnell D. Is comorbidity with ADHD a marker for juvenile-onset mania?. J Am Acad Adolesc Psychiatry. 1997b; 36/8 1046-1055
- 26 Lewinsohn P M, Klein D N, Seeley J R. Bipolar disorder during adolescence and young adulthood in a community sample. Bipor Disord. 2000; 2 281-293
- 27 Kim E Y, Miklowitz D J. Childhood mania, attention deficit hyperactivity disorder and conduct disorder: a critical review of diagnostic dilemmas. Bipol Disord. 2002; 4 215-225
- 28 Kent L, Craddock N. Is there a relationship between attention deficit hyperactivity disorder and bipolar disorder?. J Affect Disord. 2003; 73 211-221
- 29 Geller B, Craney J L, Bolhofner K, Nickelsburg M J, Williams M, Zimerman B. Two-year prospective follow-up of children with a prepubertal and early adolescent bipolar and early adolescent bipolar disorder phenotype. Am J Psychiatry. 2002a; 159 927-933
- 30 Koukopoulos A, Sani G, Koukopoulos A E, Minnai G P, Girardi P, Pani L, Albert M J, Reginaldi D. Duration and stability of the rapid-cycling course: a long-term personal follow-up of 109 patients. J Affect Disord. 2003; 73 75-85
- 31 Lish J D, Dime-Meenan S, Whybrow P C, Price R A, Hirschfeld R MA. The national Depressive and Manic-depressive Association (DMDA) survey of bipolar members. J Affect Disorder. 1994; 31 281-294
- 32 Strober M, Schmidt-Lackner S, Freeman R, Bower S, Lampert C, DeAntonio M. Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up. J Am Acad Child Adolesc Psychiatry. 1995; 34/6 724-731
- 33 Lewinsohn P M, Seeley J R, Buckley M E, Klein D N. Bipolar disorder in adolescence and young adulthood. Child Adolesc Psychiat North Am. 2002; 11 461-475
- 34 Werry J S, McClellan J M. Predicting outcome in child and adolescent (early onset) schizophrenia and bipolar disorder. J Am Acad Child Adolesc Psychiatry. 1992; 31/1 147-150
- 35 Benazzi F. Age at onset of bipolar II depressive mixed state. Psychiatry Res. 2001; 103 229-235
- 36 Benazzi F. Bipolar II depressive mixed state: finding a useful definition. Comprehens Psychiatry. 2003; 44/1 21-27
- 37 Benazzi F, Akiskal H S. Refining the evaluation of bipolar II: beyond the strict SCID-CV guidelines for hypomania. J Affect Disord. 2003; 73 33-38
- 38 Angst J, Gamma A. A new bipolar spectrum concept: a brief review. Bipol Disord. 2002; 4 suppl 1 11-14
- 39 Perugi G, Akiskal H S, Micheli C, Toni C, Madaro D. Clinical characterization of depressive mixed state in bipolar-I patients: Pisa - San Diego collaboration. J Affect Disord. 2001; 67 105-114
- 40 Perugi G, Akiskal H S. The soft pectrum redefined: focus on the cyclothymic, anxious-sensitive, impuls-dyscontrol, and binge-eating connection inbipolar II and releated conditions. Psychiat Clin North Am. 2002; 25 713-737
- 41 Perry A, Tarrier N, Morriss E, Limb K. Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment. Brit Med J. 1999; 318 149-153
- 42 Kowatch R A, Frisatd M, Birmaher B, Wagner K D, Findling R L, Hellander M. and the Child Psychiatric workgroup on bipolar disorder . Treatment Guidelines for children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2005; 44 (3) 213-235
- 43 Davanzo P A, McCracken J T. Mood stabilizer in the treatment of juvenile bipolar disorder. Child Adolesc Psychiat Clin North Am. 2000; 9/1 159-182
- 44 Montgomery S A, Keck P E. First international exchange on bipolar disorder. J Affect Disord. 2000; 59 S81-S88
- 45 Botteron K N, Geller B. Pharmacologic treatment of childhood and adolescent mania. Child Adolesc Psychiat Clin North Am. 1995; 4/2 283-304
- 46 James A CD, Javaloyes A M. Practitioner review: the treatment of bipolar disorder in children and adolescents. J Child Psychol Psychiatry. 2001; 42/4 439-449
- 47 Schou M. Lithium treatment at 52. J Affect Disord. 2001; 67 21-32
- 48 Burgess S, Geddes J, Hawton K, Townsend E, Jamison K, Goodwin G. The cochrane database of systematic reviews. Lithium for maintenance treatment of mood disorders. 2003 Volume (1)
- 49 Wagner K D, Weller E B, Carlson G A, Sachs G, Biederman J, Frazier J A, Wozniak P, Tracy K, Weller R, Bowden C. An open-label trial of divalproex in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2002; 41/10 1224-1230
- 50 Barrios C, Chaudhry T A, Goodnick P J. Rapid cycling bipolar disorder. Expert Opin Pharmacother. 2001; 2/12 1963-1973
- 51 Post R M, Frye M A, Denicoff K D, Leverich G S, Dunn R T, Osuch E A, Speer A M, Obrocea G, Jajodia K. Emerging trends in the treatment of rapid cycling bipolar disorder: a selected review. Bipol Disord. 2000; 2 305-315
- 52 Greil W, Kleindienst N. Lithium versus Carbamazepin in the maintenance treatment of bipolar II disorder and bipolar disorder not otherwise specified. Int Clin Psychopharmacol. 1999a; 14/5 283-285
- 53 Greil W, Kleindienst N. The comparative prophylactic efficacy of lithium and carbamazepine in patients with bipolar I disorder. Int Clin Psychopharmacol. 1999b; 14/5 277-281
- 54 Kowatch R A, Suppes T, Carmody T J, Bucci J P, Hume J H, Kromelis M, Emslie G J, Weinberg W A, Rush A J. Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2000; 39/6 713-720
- 55 Keck P E, Mendlewitz J, Calabrese J R, Fawcett J, Suppes T, Vestergaard A, Carbonell C. A review of randomized, controlled clinical trials in acute mania. J Affect Disord. 2000; 59 S31-S37
- 56 Yatham L N, Kusumakar V, Calabrese J R, Scarrow G, Kroeker G. Third generation anticonvulsants in bipolar disorder: a review of efficacy and summary of clinical recommendations. J Clin Psychiatry. 2002; 63 275-283
- 57 Bowden C L, Karren N U. Lamotrigine in the treatment of bipolar disorder. Expert Opin Pharmacother. 2002; 3/10 1513-1519
- 58 Calabrese J R, Melvin D S, Shelton M D, Rapport D J, Kimmel S E. Bipolar disorders and the effectiveness of novel anticonvulsants. J Clin Psychiatry. 2002a; 63, suppl 3 5-9
- 59 Ichim L, Berk M, Brook S. Lamotrigine compared with lithium in mania: a double-blind randomized controlled trial. ANN J Psychiatry. 2000; 12/1 5-10
- 60 MacDonald K J, Young L T. Newer antiepileptic drugs in bipolar disorder. CNS Drugs. 2002; 16/8 549-562
- 61 Zerjav-Lacombe S, Tabarsi E. Lamotrigine: a review of clinical studies in bipolar disorders. Can J Psychiatry. 2001; 46 328-333
- 62 Calabrese J R, Shelton M D, Rapport D J, Kimmel S E, Elhaj O. Long-term treatment of bipolar disorder with lamotrigine. J Clin Psychiatry. 2002b; 63, suppl 10 18-22
- 63 Grunze H, Walden J. Relevance of new and newly rediscovered anticonvulsants for atypical forms of bipolar disorder. J Affect Disord. 2002; 72 S15-S21
- 64 Overstreet K, Costanza C, Behling C, Hassanin T, Masliah E. Fatal progressive hepatic necrosis associated with lamotrigine treatment. Dig Dis Sci. 2002; 47/9 1921-1925
- 65 Chengappa K NR, Gershon S, Levine J. The evolving role of topiramate among other mood stabilizers in the management of bipolar disorder. Bipol Disord. 2001; 3 215-232
- 66 Ghaemi S N, Lenox M S, Baldessarini R J. Effectiveness and safety of long-term antidepressant treatment in bipolar disorder. J Clin Psychiatry. 2001a; 62/7 565-569
- 67 Guille C, Sachs G. Clinical outcome of adjunctive topiramate treatment in a sample of refractory bipolar patients with comorbid conditions. Progr Neuro Psychopharmacol Biol Psychiatry. 2002; 26 1035-1039
- 68 Suppes T. Review of the use of topiramate for treatment of bipolar disorders. J Clin Psychopharmacol. 2002; 22 599-609
- 69 Carta M G, Hardoy M C, Hardoy M J, Grunze H, Carpiniello B. The clinical use of gabapentin in bipolar spectrum disorders. J Affect Disord. 2003; 75 83-91
- 70 Hamrin V, Bailey K. Gabapentin and methylphenidate treatment of a preadolescent with attention deficit hyperactivity disorder and bipolar disorder. J Child Adolesc Psychopharmacol. 2001; 11/3 301-309
- 71 Hellewell J SE. Oxcarbazepin (Trileptal) in the treatment of bipolar disorders: a review of efficacy and tolerability. J Affect Disord. 2002; 72 S23-S34
- 72 Pande A C, Crockatt J G, Janney C A, Werth J L, Tsaroucha G. Gabapentin in bipolar disorder: aplacebo-controlled trial of adjunctive therapy. Bipol Disord. 2000; 2 249-255
- 73 Wang P W, Santosa C, Schmacher M, Winsberg M E, Strong C, Ketter T A. Gabapentin augmentation therapy in bipolar depression. Bipol Disord. 2002; 4 296-301
- 74 Miller D S, Yatham L N, Lam R W. Comparative efficacy of typical and atypical antipsychotics as add-on therapy to mood stabilizers in the treatment of acute mania. J Clin Psychiatry. 2001; 62 975-980
- 75 Chengappa K NR, Baker R W, Shao L, Tohen M, Gershon S, Kupfer D J. Rates of response, euthymia and remission in two placebo-controlled olanzapine trials für bipolar mania. Bipolar Disord. 2003; 5 1-5
- 76 DelBello M P, Schwiers M L, Rosenberg H L, Strakowski S M. A double blind, randomized, placebo-controlled study of Quetiapine as adjunctive treatment for adlescent mania. J Am Acad Child Adolesc Psychiatry. 2002; 41/10 1216-1223
- 77 Frazier J A, Biederman J, Tohen M, Feldman P D, Jacobs T G, Toma V, Rater M A, Tarazi R A, Kim G S, Garfield S B, Sohma M, Gonzales-Heydrich J, Risser R C, Nowlin Z M. A prospective open-label treatment trial of Olanzapine monotherapy in children and adolescents with bipolar disorder. J Child Adolesc Psychopharmacol. 2001; 11/3 239-250
- 78 Khouzam H R, El-Gabalawi F. Treatment of bipolar I disorder in an adolescent with olanzapine. J Child Adolesc Psychopharmacol. 2000; 10/2 147-151
- 79 Tohen M, Jacobs T G, Grundy S L, McElroy S L, Banov M C, Janicak P G, Sanger T, Risser R, Zhang F, Toma V, Francis J, Tollefson G D, Breier A. Efficacy of olanzapine in acute bipolar mania. Arch Gen Psychiatry. 2000; 57 841-849
- 80 Vieta E, Parramon G, Padrell E, Nieto E, Martinez-Arán A, Corbella B, Colom F, Reinares M, Goikolea J M, Torrent C. Quetiapine in the treatment of rapid cycling bipolar disorder. Bipol Disord. 2002b; 4 335-340
- 81 Aubry J M, Simon A E, Bertschy G B. Possible induction of mania and hypomania by Olanzapine or Risperidone: a critical review of reported cases. J Clin Psychiatry. 2000; 61 649-655
- 82 Baldassano C F, Ballas C, Datto S M, Kim D, Littman L, O'Reardon J, Rynn M A. Ziprasidone-associated mania: a case series and review of the mechanism. Bipol Disord. 2003; 5 72-75
- 83 Benazzi F. Olanzapine-induced psychotic mania in bipolar schizo-affective disorder. Eur Psychiatry. 1999; 14 410-411
- 84 Ahmed Z, Anderson I M. Treatment of bipolar affective disorder in clinical practice. J Psychopharmacol. 2001; 15/1 5-57
- 85 Have M ten, Vollebergh W, Bijl R, Nolen W A. Bipolar disorder in the general population in The Netherlands (prevalence, consequences and care utilisation): results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). J Affect Disord. 2002; 68 203-213
- 86 Sachs G S, Grossman F, Ghaemi S N, Okamoto A, Bowden C L. Combination of a mood stabilizer with risperidone or haloperidol for treatment of acute mania: a double-blind, placebo-controlled comparison of efficacy and safety. Am J Psychiatry. 2002; 159 1146-1154
- 87 Sajatovic M, Brescan D W, Perez D E, DiGiovanni S K, Hattab H, Ray J B, Bingham C R. Quetiapine alone and added to amood stabilizer for serious mood disorders. J Clin Psychiatry. 2001; 62 728-732
- 88 Tohen M, Chengappa K NR, Suppes T, Zarate C A, Calabrese J R, Bowden C L, Sachs G S, Kupfer D J, Baker R W, Risser R C, Keeter E L, Feldman P D, Tollefson G D, Breier A. Efficacy of olanzapine in combination with valproate or lithium in the treatment of mania in patients partially nonresponsive to valproate or lithium monotherapy. Arch Gen Psychiatry. 2002; 59 62-69
- 89 Goodnick P J. The use of nimodipine in the treatment of mood disorders. Bipolar Disord. 2000; 2 165-173
- 90 Baumann B, Bogerts B. Neuroanatomical studies on bipolar disorder. Brit J Psychiatry. 2001; 178, suppl 41 s142-s147
- 91 Strakowski S M, DelBello M P, Zimmerman M E, Getz G E, Mills N P, Ret J, Shear P, Adler C M. Ventricular and periventricular structural volumes in first- versus multiple-episode bipolar disorder. Am J Psychiatry. 2002; 159 1841-1847
- 92 Cecil K M, DelBello M P, Morey R, Strakowski S M. Frontal lobe differences in bipolar disorder as determined by proton MR spectroscopy. Bipol Disord. 2002; 4 357-365
- 93 Moore P B, Sheperd D J, Eccleston D, Macmillan I C, Goswami U, McAllister V L, Ferrier I N. Cerebral white matter lesions in bipolar affective disorder: relationship to outcome. Brit J Psychiatry. 2001; 178 172-176
- 94 Blackwood D HR, Visscher P M, Muir W J. Genetic studies of bipolar affective disorder in large families. Brit J Psychiatry. 2001; 178, suppl 41 s134-s136
- 95 Quraishi S, Frabgou S. Neuropsychology of bipolar disorder: a review. J Affect Disord. 2002; 72 209-226
Dr. med. Oliver Bilke
Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie · Vivantes-Humboldt-Klinikum
Frohnauerstraße 74 - 80
13467 Berlin
Email: oliver.bilke@vivantes.de