Definition der Manie nach ICD-10
Gemäss Definition in der ICD-10 handelt es sich bei einer Manie um eine abgrenzbare, mindestens 1 Woche andauernde Periode mit gehobener, expansiver oder gereizter Stimmung, wobei für die Diagnosestellung noch drei weitere Kriterien aus einer Auswahlliste erfüllt sein müssen (bei der gerezten Variante 4 weitere Kriterien), die die Aktivität/Psychomotorik, die Gesprächigkeit, die Koonzentrationsfähigkeit resp. Ablenkbarkeit, das formale Denken, das Schlafbedürfnis, die Libido, das Nähe-Distanz-/ und sonstige zwischenmenschliche und gesellschaftliche Verhalten sowie den Realitätsbezug von Denken, Planen und Verhalten anbetrifft. Die aus den Normabweichungen resultierenden Beeinträchtigungen der Lebensführung müssen schwer sein.
Die genauen Kriterien finden Sie im Kapitel Diagnostik
Definition der Hypomanie nach ICD-10
Für die Definition der Hypomanie gelten im Grunde dieselben Kriterien wie für die Manie (s. o.). Allerdings müssen die Symptome nur 4 Tage bestehen, sie sollten graduell schwächer ausgeprägt sein als bei der Manie, dürfen keine psychotische Wahrnehmungsverzerung oder für die Manie charakteristische Denkstörungen aufweisen und die Lebensführung sollte nur leichtgradig oder gar nicht beeinträchtigt sein.
Einzelheiten im Kapitel zur Manie-Diagnostik
Definition der manisch-depressiven (bipolaren) Störung – bipolar-I und bipolar-II nach ICD-10
Laut Definition in der ICD-10 ist eine manisch-depressive bzw. bipolare Störung gekennzeichnet durch einen Wechsel von depressiven und manischen Krankheits-Phasen. Depressive Phasen zeigen dieselben Symptome wie im Kapitel Depressionen beschrieben. Manische Phasen zeigen die oben und im Kapitel zur Manie-Diagnostik beschriebene Symptomatik. Der Wechsel ist meist nicht regelmässig, in der Regel überwiegen depressive Phasen zahlenmässig deutlich. Zwischen den Krankheitsphasen wird oft eine Vollremission erreicht, es gibt aber auch Verläufe mit unvollständiger Remission. Es wird unterschieden zwischen einer bipolar-I-Erkrankung (MD plus Manie) und einer bipolar-II-Erkrankung (MD plus Hypomanie). Wenn innerhalb eines Jahres mindestens vier Krankheitsepisoden auftreten, spricht man von einem „rapid cycling“-Verlauf, der eine besonders ungünstige Prognose hat.
Die Einteilung nach ICD-10 finden Sie im Kapitel Diagnostik der Manie
Sonderform: Rapid cycling
Erleiden Betroffene innerhalb eines Jahres mindestens vier Krankheitsepisoden, spricht man von einem „rapid cycling“
Definition der Zyklothymie
Nach DSM-IV bestehen bei der meist im Jugendalter beginnenden „Zyklothymie“ für die Dauer von mindestens zweiJahren (bei Kindern und Heranwachsenden mindestens 1 Jahr) zahlreiche Perioden mit hypomanischen Symptomen und zahlreiche Perioden mit depressiven Symptomen, die nicht die Kriterien einer Episode einer Major Depression erfüllen. Die Symptomfreiheit zwischen den Phasen ist kürzer als 2 Monate, die Störungen sind nicht durch andere Diagnosen besser zu erklären und nicht durch zugeführte Substanzen oode somatische Krankheitsfaktoren erklärbar. Die Störung verursacht ein bedeutsames Leiden. Es ist möglich, dass gleichzeitig eine Bipolar-I-Störung oder eine Bipolar-II-Störung vorliegt und ebenfalls diagnostizoert werden muss.
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