| H01653 | |
| H番号 | H01653 |
| 名称 | 双極性障害; 躁うつ病 |
| 概要 | Bipolar disorder, previously known as manic depressive illness, is a severe chronic mood disorder, characterized by the recurrence of mania (hypomania), depression, or mixed episodes. It is one of the main causes of disability among young people, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. Mania is the most characteristic phase of bipolar disorder. While mood elevation and euphoria are commonly described phenotypic descriptors of mania, irritability and anger may dominate. At the present time, there is solid evidence supporting the use of lithium, the anticonvulsants valproate and carbamazepine, and some antipsychotics in mania. Manic or hypomanic episodes differ in severity and length. In a hypomanic episode, a disturbance in functioning can be seen by others but does not typically cause severe impairment or require admission to hospital. At onset, most patients with bipolar disorder present with a depressive episode that differs subtly from unipolar depression. The first step in the management of bipolar disorder is to confirm the diagnosis of mania or hypomania and define the patient's mood state, because the therapeutic approach differs considerably for hypomania, mania, depression, and euthymia. While effective pharmacological treatments exist for bipolar disorder, the pathophysiology of the condition essentially remains unknown. Although bipolar disorder is one of the most heritable psychiatric disorders, a multifactorial model in which gene and environment interact is currently thought to best fit this disorder. Many risk alleles of small effect which are described in genome-wide association studies, contribute to the polygenic risk of bipolar disorder. It is suggested that the dopaminergic system may play a central role in bipolar disorder, although no singular dysfunction of neurotransmitter systems has been identified. |
| カテゴリ | 精神及び行動の障害 |
| ネットワーク | - |
| 病因遺伝子 | (MAFD7) XBP1 [HSA:7494] [KO:K09027] |
| 病原体 | - |
| 環境要因 | - |
| 発癌物質 | - |
| 治療薬 | カルバマゼピン [DR:D00252] バルプロ酸ナトリウム [DR:D00710] ラモトリギン [DR:D00354] クロルプロマジン塩酸塩 [DR:D00789] クロルプロマジンフェノールフタリン酸塩 [DR:D04034] レボメプロマジン塩酸塩 [DR:D01520] レボメプロマジンマレイン酸塩 [DR:D02248] ハロペリドール [DR:D00136] ルラシドン塩酸塩 [DR:D04820] オランザピン [DR:D00454] クエチアピンフマル酸塩 [DR:D00458] スルトプリド塩酸塩 [DR:D02208] 炭酸リチウム [DR:D00801] アリピプラゾール [DR:D01164] チミペロン [DR:D02035] |
| コメント | Bipolar I disorder: At least one manic episode must be presented, although major depressive episodes are typical but not needed for diagnosis. Bipolar II disorder: At least one hypomanic episode and one major depressive episode are needed for diagnosis. See also H01646 Major depressive disorder. |
| リンク | ICD-11: 6A60 6A61 ICD-10: F31 MeSH: D001714 OMIM: 125480 309200 612371 |
| 文献 | PMID:26388529 著者 Grande I, Berk M, Birmaher B, Vieta E タイトル Bipolar disorder. 雑誌 Lancet 387:1561-72 (2016) DOI:10.1016/S0140-6736(15)00241-X PMID:25497471 著者 Graham RK, Parker GB, Breakspear M, Mitchell PB タイトル Clinical characteristics and temperament influences on 'happy' euphoric and 'snappy' irritable bipolar hypo/manic mood states. 雑誌 J Affect Disord 174:144-9 (2015) DOI:10.1016/j.jad.2014.11.042 PMID:19922550 著者 Cousins DA, Butts K, Young AH タイトル The role of dopamine in bipolar disorder. 雑誌 Bipolar Disord 11:787-806 (2009) DOI:10.1111/j.1399-5618.2009.00760.x PMID:23361832 著者 Citrome L タイトル Cariprazine in bipolar disorder: clinical efficacy, tolerability, and place in therapy. 雑誌 Adv Ther 30:102-13 (2013) DOI:10.1007/s12325-013-0004-9 PMID:18689287 著者 Vieta E, Sanchez-Moreno J タイトル Acute and long-term treatment of mania. 雑誌 Dialogues Clin Neurosci 10:165-79 (2008) PMID:12949534 著者 Kakiuchi C, Iwamoto K, Ishiwata M, Bundo M, Kasahara T, Kusumi I, Tsujita T, Okazaki Y, Nanko S, Kunugi H, Sasaki T, Kato T タイトル Impaired feedback regulation of XBP1 as a genetic risk factor for bipolar disorder. 雑誌 Nat Genet 35:171-5 (2003) DOI:10.1038/ng1235 |