Skip to main content
SpringerLink
Log in

Psychotherapie für Menschen mit bipolaren Störungen

Übersicht über evidenzbasierte Verfahren und neuere Entwicklungen

Psychotherapy for people with bipolar disorders

An overview of evidence-based procedures and new developments

  • Leitthema
  • Published:
Der Nervenarzt Aims and scope Submit manuscript

Zusammenfassung

Zahlreiche Einzelstudien und Metaanalysen zeigen, dass psychotherapeutische Interventionen bei Menschen mit bipolaren Störungen den Krankheitsverlauf positiv beeinflussen können. Der Artikel gibt eine Übersicht über die Entwicklung der Psychotherapie für Menschen mit bipolaren Störungen, es werden die nach den aktuellen Leitlinien evidenzbasierten Verfahren mit ihren Wirkprinzipien vorgestellt, sowie neuere Entwicklungen der Psychotherapieforschung in diesem Feld skizziert.

Abstract

Many individual studies and meta-analyses have shown that psychotherapeutic interventions for people with bipolar disorders can positively influence the course of the disease. This article gives an overview of the development of psychotherapy for people with bipolar disorders. According to the current guidelines the evidence-based procedures with their mechanisms of action are presented and new developments in psychotherapy research in this field are outlined.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Abraham K (1912) Ansätze zur psychoanalytischen Erforschung und Behandlung des manisch-depressiven Irreseins und verwandter Zustände. Zentralbl Psychoanal Psychother 2:302–315

    Google Scholar 

  2. Angst J (1966) Zur Ätiologie und Nosologie endogener depressiver Psychosen. Springer, Berlin, Heidelberg, New York

    Book  Google Scholar 

  3. Angst J, Stassen HH, Clayton PJ et al (2002) Mortality of patients with mood disorders: follow-up over 34–38 years. J Affect Disord 68:167–181

    Article  CAS  PubMed  Google Scholar 

  4. Aqua-Institut (2015) Ambulante psychotherapeutische Versorgung gesetzlich Krankenversicherter. Aqua-Institut, Göttingen (www.aqua-institut.de)

    Google Scholar 

  5. Ball J, Mitchell P, Malhi G, Skillecorn A, Smith M (2003) Schema-focused cognitive therapy for bipolar disorder: reducing vulnerability to relapse through attitudinal change. Aust N Z J Psychiatry 37:41–48

    Article  PubMed  Google Scholar 

  6. Berk M, Post R, Ratheesh A, Gliddon E, Singh A, Vieta E, Carvalho AF, Ashton MM, Berk L, Cotton SM, McGorry PD, Fernandes BS, Yatham LN, Dodd S (2017) Staging in bipolar disorder: From theoretical framework to clinical utility. World Psychiatry 16:236–244

    Article  PubMed  PubMed Central  Google Scholar 

  7. Binswanger L (1960) Melancholie und Manie. Phänomenologische Studien. Neske, Pfullingen

    Google Scholar 

  8. Carney SM, Goodwin GM (2005) Lithium – a continuing story in the treatment of bipolar disorder. Acta Psychiatr Scand Suppl 426:7–12

    Article  CAS  Google Scholar 

  9. Colom F, Vieta E (2006) Psychoeducation model for bipolar disorder. University Press, Cambridge

    Book  Google Scholar 

  10. Deckersbach T, Peters AT, Sylvia L, Urdahl A, Magalhaes PVS, Otto MW, Frank E, Miklowitz DJ, Berk M, Kinrys G, Nierenberg A (2014) Do comorbid anxiety disorders moderate the effects of psychotherapy for bipolar disorder? Results from STEP-BD

    Google Scholar 

  11. DGBS e. V. und DGPPN e.V (2012) S3-Leitlinie zur Diagnostik und Therapie Bipolarer Störungen. Langversion

    Google Scholar 

  12. D’Souza R, Piskulic D, Sundram S (2010) In recently remitted bipolar disorder: a pilot randomised controlled trial. J Affect Disord 120:272–276

    Article  PubMed  Google Scholar 

  13. Frank E (2005) Treating bipolar disorder: a clinician’s guide to interpersonal and social rhythm therapy. Guilford, New York

    Google Scholar 

  14. Frank E, Hlastala S, Ritenour A, Houck P, Tu XM, Monk TH, Mallinger AG, Kupfer DJ (1997) Inducing lifestyle regularity in recovering bipolar disorder patients: results from the maintenance therapies in bipolar disorder protocol. Psychiatry 41(12):1165–1173

    CAS  Google Scholar 

  15. Freud S (1917) Trauer und Melancholie: Studienausgabe Band III. Fischer, Frankfurt a.M.

    Google Scholar 

  16. Fromm-Reichmann F (1949) Intensive psychotherapy of manic-depressives. Confin Neurol 9:158–165

    Article  CAS  PubMed  Google Scholar 

  17. Gemeinsamer Bundesausschuss (2014) http://www.g-ba.de/informationen/beschluesse/2087/. Zugegriffen: 24.01.2018

  18. Gomes BC, Rocca CC, Belizario GO, Lafer B (2017) Cognitive-behavioral rehabilitation vs. treatment as usual for bipolar patients: study protocol for a randomized controlled trial. Trials 18:142

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gonzales Isasi A, Echeburua E, Liminana JM, Gonzales-Pinto A et al (2014) Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: a 5‑year controlled clinical trial. Eur Psychiatry 29:134–141

    Article  Google Scholar 

  20. Gonzalez Isasi A, Echeburua E, Liminana JM, Gonzalez-Pinto A (2010) How effective is a psychological intervention program for patients with refractory disorder? A randomized controlled trial. J Affect Disord 126:80–87. https://doi.org/10.1016/j.jad.2010.03.026

    Article  Google Scholar 

  21. Haffner P, Quinlivan E, Fiebig J, Sondergeld LM, Strasser ES, Adli M, Moritz S, Stamm TJ (2017) Improving functional outcome in bipolar disorder: a pilot study on metacognitive training. Clin Psychol Psychother. https://doi.org/10.1002/cpp.2124

    PubMed  Google Scholar 

  22. Hawke LD, Provencher MD (2012) Early maladaptive Schemas among patients diagnosed with bipolar disorder. J Affect Disord 136(3):803–811

    Article  PubMed  Google Scholar 

  23. Hawke LD, Provencher MD, Arntz A (2011) Early maladaptive Schemas in the risk for bipolar spectrum disorders. J Affect Disord 133(3):428–436

    Article  PubMed  Google Scholar 

  24. Javadpour A, Hedayati A, Dehbozorgi GR, Azizi A (2012) The impact of a simple individual psycho-education program on quality of life, rate of relapse and medication adherence in bipolar disorder patients. Asian J Psychiatr 6:208–213

    Article  Google Scholar 

  25. Johnson FN (1986) Different treatment modalities for recurrent bipolar affective disorders: an integrative approach. Psychother Psychosom 46:13–22

    Article  CAS  PubMed  Google Scholar 

  26. Judd LL, Schettler PJ, Akiskal HS, Coryell W, Leon AC, Maser JD, Solomon DA (2008) Residual symptom recovery from major affective episodes in bipolar disorders and rapid episode relapse/recurrence. Arch Gen Psychiatry 65(4):386–394

    Article  PubMed  Google Scholar 

  27. Klatte R, Pabst S, Beelmann A, Rosendahl J (2016) The efficacy of body-oriented yoga in mental disorders – a systematic review and meta-analysis. Dtsch Arztebl Int 113:195–202

    PubMed  PubMed Central  Google Scholar 

  28. Köhler S, Friedel E, Stamm TJ (2017) Rapid cycling in bipolar disorders: symptoms, background and treatment recommendations. Fortschr Neurol Psychiatr 85:199–211

    Article  PubMed  Google Scholar 

  29. Kraepelin E (1899) Psychiatrie. Ein Lehrbuch für Studirende und Aerzte, 6. Aufl. J. A. Barth, Leipzig

    Google Scholar 

  30. Lambert M, Niehaus V, Correll C (2016) Pharmacotherapy in children and adolescents at clinical-high risk for psychosis and bipolar disorder. Pharmacopsychiatry 49(6):229–244

    Article  CAS  PubMed  Google Scholar 

  31. Lambert M, Schöttle D, Ruppelt F, Rohenkohl A, Sengutta M, Luedecke D, Nawara LA, Galling B, Falk AL, Wittmann L, Niehaus V, Sarikaya G, Rietschel L, Gagern C, Schulte-Markwort M, Unger HP, Ott S, Romer G, Daubmann A, Wegscheider K, Correll CU, Schimmelmann BG, Wiedemann K, Bock T, Gallinat J, Karow A (2017) Early detection and integrated care for adolescents and young adults with psychotic disorders: the ACCESS III study. Acta Psychiatr Scand 136(2):188–200

    Article  CAS  PubMed  Google Scholar 

  32. Lewandowski KE, Sperry SH, Cohen BM, Norris LA, Fitzmaurice GM, Ongur D, Keshavan MS (2017) Treatment to Enhance Cognition in Bipolar Disorder (TREC-BD): Efficacy of a Randomized Controlled Trial of Cognitive Remediation Versus Active Control. J Clin Psychiatry 78:e1242–e1249

    Article  PubMed  Google Scholar 

  33. McElroy SL, Altshuler LL, Suppes T, Keck PE Jr, Frye MA, Denicoff KD, Nolen WA, Kupka RW, Leverich GS, Rochussen JR, Rush AJ, Post RM (2001) Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am J Psychiatry 158:420–426

    Article  CAS  PubMed  Google Scholar 

  34. Mentzos S (1995) Depression und Manie: Psychodynamik und Therapie affektiver Störungen. Vandenhoeck & Ruprecht, Göttingen

    Google Scholar 

  35. Meyer TD, Hautzinger M (2004) Bipolare Störungen: Kognitiv-verhaltenstherapeutisches Behandlungsmanual. Beltz, Weinheim

    Google Scholar 

  36. Meyer TD, Hautzinger M (2012) Cognitive behavioral therapy as supplement to pharmacotherapy of manic depressive disorders. What is the empirical basis? Psychol Med 42:1429–1439

    Article  CAS  PubMed  Google Scholar 

  37. Miklowitz DJ, Chung B (2016) Family-focused therapy for bipolar disorder: reflections on 30 years of research. Fam Process 55:483–499

    Article  PubMed  Google Scholar 

  38. Miklowitz DJ, Goldstein JM (1997) Bipolar disorder: a family-focused treatment approach. Guilford, New York

    Google Scholar 

  39. Miklowitz DJ, Otto MW, Frank E, Reilly-Harrington NA, Kogan JN, Sachs GS, Thase ME, Calabrese JR, Marangell LB, Araga M, Gonzales JM, Wisniewski SR (2007a) Intensive psychosocial intervention enhances funktioning in patients with bipolar depression: results from a 9-month randomized controlled trial. Am J Psychiatry 164:1240–1247

    Article  Google Scholar 

  40. Miklowitz DJ, Otto MW, Frank E, Reilly-Harrington NA, Wisniewski SR, Kogan JN, Nierenberg AA, Calabrese JR, Marangell LB, Guylai L, Araga M, Gonzales JM, Shirley ER, Thase ME, Sachs GS (2007b) Psychosocial treatments for bipolar depression: a 1-year randomized trial for the systematic treatment enhancement program. Arch Gen Psychiatry 64(4):419–426

    Article  PubMed  PubMed Central  Google Scholar 

  41. Miklowitz DJ, Schneck CD, Walshaw PD, Garrett AS, Singh MK, Sugar CA, Chang KD (2017) Early intervention for youth at high risk for bipolar disorder: a multisite randomized trial of family-focused treatment. Acta Psychiatr Scand 136:188–200

    Article  Google Scholar 

  42. Mühlig S, Bernd C, Haarig F (2014) Wie wirksam sind Psychotherapien bei Bipolaren Störungen im Vergleich: Ergebnisse einer Cochrane-Analyse. DGBS Jahrestagung. Vortrag.

    Google Scholar 

  43. Murray G, Leitan ND, Thomas N, Michalak EE, Johnson SL, Jones S, Perich T, Berk L, Berk M (2017) Towards recovery-oriented psychosocial interventions for bipolar disorder: quality of life outcomes, stage-sensitive treatments, and mindfulness mechanisms. Clin Psychol Rev 52:148–163

    Article  PubMed  Google Scholar 

  44. Parikh SV, Zaretsky A, Beaulieu S, Yotham LN, Young LT, Patelis-Siotis I, MacQueen GM, Levitt A, Arenovich T, Cervantes P, Velyvis V, Kennedy SH, Streiner DL (2012) A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: A canadian network for mood and anxiety treatments (CANMAT) study. J Clin Psychiatry 73(6):803–810

    Article  PubMed  Google Scholar 

  45. Perich T, Manicavasagar V, Michell PB, Ball JR, Hadzi-Pavlovic D (2012) A randomized controlled trial of mindfulness-based cognitive therapie for bipolar disdorder. Acta Psychiatr Scand 127:333–343

    Article  PubMed  Google Scholar 

  46. Pfennig A, Correll CU, Marx C, Rottmann-Wolf M, Meyer TD, Bauer M, Leopold K (2013a) Psychotherapeutic interventions in individuals at risk of developing bipolar disorder: a systematic review. Early Interv Psychiatry 8:3–11

    Article  PubMed  Google Scholar 

  47. Pfennig A, Bschor T, Falkai P, Bauer M (2013b) Clinical practice guideline:The diagnosis and treatment of bipolar disorder – recommendations from the current S3 guideline. Dtsch Arztebl Int 110(6):92–100

    PubMed  PubMed Central  Google Scholar 

  48. Pfennig A, Leopold K, Bechdolf A, Correll CU, Holtmann M, Lambert M, Marx C, Meyer TD, Pfeiffer S, Reif A, Rottmann-Wolf M, Schmitt NM, Stamm T, Juckel G, Bauer M (2014) Early specific cognitive-behavioural psychotherapy in subjects at high risk for bipolar disorders: study protocol for a randomised controlled trial. Trials 15:161

    Article  PubMed  PubMed Central  Google Scholar 

  49. Pfennig A, Leopold K, Ritter P, Böhme A, Severus E, Bauer M (2017) Longitudinal changes in the antecedent and early manifest course of bipolar disorder – a narrative review of prospective studies. Aust N Z J Psychiatry 51:509–523

    Article  PubMed  Google Scholar 

  50. Post RM (1992) Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 149:999–1010

    Article  CAS  PubMed  Google Scholar 

  51. Bonnin CM, Torrent C, Arango C, Amann BL, Solé B, González-Pinto A, Crespo JM, Tabarés-Seisdedos R, Reinares M, Ayuso-Mateos JL, García-Portilla MP, Ibañez Á, Salamero M, Vieta E, Martinez-Aran A, Remediation Group (2016) Functional remediation in bipolar disorder: 1‑year follow-up of neurocognitive and functional outcome. Br J Psychiatry 208:87–93

    Article  CAS  PubMed  Google Scholar 

  52. Ritter PS, Bermpohl F, Gruber O, Hautzinger M, Jansen A, Juckel G, Kircher T, Lambert M, Mulert C, Pfennig A, Reif A, Rienhoff O, Schulze TG, Severus E, Stamm T, Bauer M (2016) Aims and structure of the German research consortium bipolife for the study of bipolar disorder. Int J Bipolar Disord 4(1):26. https://doi.org/10.1186/s40345-016-0066-0

    Article  PubMed  PubMed Central  Google Scholar 

  53. Sanchez-Moreno J, Martinez-Aran A, Vieta E (2017) Treatment of functional impairment in patients with bipolar disorder. Curr Psychiatry Rep 19:3

    Article  PubMed  Google Scholar 

  54. Schaub A (2004) Kognitiv-psychoedukative Therapie bei bipolaren Erkrankungen: ein Therapiemanual. Hogrefe, Göttingen

    Google Scholar 

  55. Scott J, Colom F, Vieta E (2007) A meta-analysis of relapse rates with adjunctive psychological therapies compared to usual psychiatric treatment for bipolar disorders. Int J Neuropsychopharmacol 10:123–129

    Article  CAS  PubMed  Google Scholar 

  56. Scott J, Marwaha S, Ratheesh A, Macmillan I, Yung AR, Morriss R, Hickie IB, Bechdolf A (2017) Bipolar at-risk criteria: an examination of which clinical features have optimal utility for identifying youth at risk of early transition from depression to bipolar disorders. Early Interv Psychiatry. https://doi.org/10.1111/eip.12463

    Google Scholar 

  57. Simon GE, Ludman EJ, Bauer MS, Unützer J, Operskalski B (2006) Long-term effectiveness and cost of a systematic care program for bipolar disorder. Arch Gen Psychiatry 63(5):500–508

    Article  PubMed  Google Scholar 

  58. Simon GE, Hunkeler E, Fireman B, Lee JY, Savarino J (2007) Risk of suicide attempt and suicide death in patients treated for bipolar disorder. Bipolar Disord 9:526–530

    Article  PubMed  Google Scholar 

  59. Simon NM, Otto MW, Wisniewski SR, Fossey M, Sagduyu K, Frank E, Sachs GS, Nierenberg AA, Thase ME, Pollack MH (2004) Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry 161:2222–2229

    Article  PubMed  Google Scholar 

  60. Swartz HA, Rucci P, Thase ME, Wallace M, Carretta E, Celedonia KL, Frank E (2017) Psychotherapy alone and combined with medication as treatments for bipolar II depression: A randomized controlled trial. J Clin Psychiatry. https://doi.org/10.4088/JCP.16m11027

    PubMed  Google Scholar 

  61. Torrent C, Bonnin Cdel M, Martínez-Arán A, Valle J, Amann BL, González-Pinto A, Crespo JM, Ibáñez Á, Garcia-Portilla MP, Tabarés-Seisdedos R, Arango C, Colom F, Solé B, Pacchiarotti I, Rosa AR, Ayuso-Mateos JL, Anaya C, Fernández P, Landín-Romero R, Alonso-Lana S, Ortiz-Gil J, Segura B, Barbeito S, Vega P, Fernández M, Ugarte A, Subirà M, Cerrillo E, Custal N, Menchón JM, Saiz-Ruiz J, Rodao JM, Isella S, Alegría A, Al-Halabi S, Bobes J, Galván G, Saiz PA, Balanzá-Martínez V, Selva G, Fuentes-Durá I, Correa P, Mayoral M, Chiclana G, Merchan-Naranjo J, Rapado-Castro M, Salamero M, Vieta E (2013) Efficacy of functional remediation in bipolar disorder: a multicenter randomized controlled study. Am J Psychiatry 170:852–859

    Article  PubMed  Google Scholar 

  62. Tse S, Yuen YM, Suto M (2014) Expected possible selves and coping skills among young and middle-aged adults with bipolar disorder. East Asian Arch Psychiatry 24:117–124

    CAS  PubMed  Google Scholar 

  63. Uebelacker LA, Weinstock LM, Kraines MA (2014) Self-reported benefits and risks of yoga in individuals with bipolar disorder. J Psychiatr Pract 20:345–352

    Article  PubMed  Google Scholar 

  64. Vallarino M, Henry C, Etain B, Gehue LJ, Macneil C, Scott EM, Barbato A, Conus P, Hlastala SA, Fristad M, Miklowitz DJ, Scott J (2015) An evidence map of psychosocial interventions for the earliest stages of bipolar disorder. Lancet Psychiatry 2:548–563

    Article  PubMed  PubMed Central  Google Scholar 

  65. Wagner P, Bräuning P (2004) Psychoedukation bei bipolaren Störungen: ein Therapiemanual für Gruppen. Schattauer, Stuttgart

    Google Scholar 

  66. Weiss RB, Stange JP, Boland EM, Black SK, LaBelle DR, Abramson LY, Alloy LB (2015) Kindling of life stress in bipolar disorder: comparison of sensitization and autonomy models. J Abnorm Psychol 124(1):4–16

    Article  PubMed  PubMed Central  Google Scholar 

  67. Wittchen H‑U, Wunderlich U, Gruschwitz S, Zaudig M (1997) Strukturiertes klinisches Interview für DSM-IV, Achse-I (SKID). Hogrefe, Göttingen

    Google Scholar 

  68. Yalom ID (2001) Theorie und Praxis der Gruppenpsychotherapie. Klett-Cotta, Stuttgart

    Google Scholar 

  69. Young JE, Klosko JS, Weishaar ME (2006) Schema therapy. A practitioner’s guide. Guilford, New York

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Ruppiner Kliniken – Medizinische Hochschule Brandenburg Theodor Fontane, Fehrbelliner Str. 38, 16816, Neuruppin, Deutschland

    T. J. Stamm & L.-M. Sondergeld

  2. Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin, Campus Mitte, Berlin, Deutschland

    T. J. Stamm

  3. Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Ruhr-Universität Bochum, Bochum, Deutschland

    G. Juckel

  4. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Dresden, Deutschland

    M. Bauer

Authors
  1. T. J. Stamm
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L.-M. Sondergeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Juckel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Bauer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. J. Stamm.

Ethics declarations

Interessenkonflikt

T. J. Stamm, L.-M. Sondergeld, G. Juckel und M. Bauer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stamm, T.J., Sondergeld, LM., Juckel, G. et al. Psychotherapie für Menschen mit bipolaren Störungen. Nervenarzt 89, 263–270 (2018). https://doi.org/10.1007/s00115-018-0482-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00115-018-0482-8

Schlüsselwörter

Keywords

Search

Navigation