[A conceptual model of the long-term configuration of manic-depressive illness (author's transl)].

A theoretical approach to manic-depressive illness is developed which explains the fundamental connection between psychopathologic symptoms and their arrangement in the course of time by means of one argument, i.e. the special variation of the diurnal organization of the drive and mood system. Elements of the model are a periodicity in a stringent sense, the hypothesis of the principal independence of the rhythmic organization of the drive system and the mood system which is postulated. In some special cases of different infradian rhythms there is a desynchronization of mood and drive which results both in a psychotic state and in rapid deformation of diurnal rhythms as well as slow interference cycles. This concept generates an interpretation of endogenity which uses only chronobiological terms; the hypothesis of somatogenesis is not implied but the physiologic systems involved are deemed to be intact, and the basic process is seen as a disturbance of the time structure of these functions. Thus, further investigation defines four fields: the depressive sleep disorder, the diurnal variation of mood, the chronobiology of the so-called mixed states and the time structure of the life-long sequence of phases and intervals. A new therapeutic concept works with artificial and fast sleep and wake periods and their transformation in order to achieve a resynchronization of the drive and mood system.