Czempiel Tabea, Mikolas Pavol, Bauer Michael, Vogel Sabrina, Ritter Philipp
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
Nervenarzt. 2025 Jan;96(1):15-22. doi: 10.1007/s00115-024-01791-6. Epub 2024 Dec 21.
Bipolar disorder (short: BD) is a severe illness with very heterogeneous trajectories. While some of the patients show no or hardly any long-term impairments, other affected individuals show substantial neurocognitive deficits with a clear decline in psychosocial functioning. Which factors influence the course of the disease is the subject of current research efforts.
This review presents the long-term course of bipolar disease and the factors influencing it. In particular, differential trajectory types are discussed. The cognitive and psychosocial functional level as well as the psychopathological characteristics of the disease are elucidated. In addition, biological factors and treatment approaches influencing the course and prognosis are identified.
Literature search using PubMed focusing on longitudinal studies over several years (see online supplement).
To date, there are only a few predictors and biomarkers that allow prediction of long-term progression. None have been sufficiently studied to enable clinical use. Appropriate pharmacological and psychotherapeutic treatment of those affected is essential to avoid renewed episodes of the disease.
The long-term course of bipolar disorder is highly heterogeneous and multifaceted. Despite intensive research efforts, no predictors have yet been identified that reliably predict the clinical course. This makes further research all the more important in order to offer individualized therapy options, develop new therapies and positively influence the course of the disease at an early stage.
双相情感障碍（简称BD）是一种病情严重、病程轨迹高度异质性的疾病。虽然一些患者没有或几乎没有长期损害，但其他患者则表现出明显的神经认知缺陷，社会心理功能明显下降。哪些因素影响疾病进程是当前研究的课题。
本综述介绍双相情感障碍的长期病程及其影响因素。特别讨论了不同的病程轨迹类型。阐述了该疾病的认知和社会心理功能水平以及精神病理学特征。此外，还确定了影响病程和预后的生物学因素及治疗方法。
使用PubMed进行文献检索，重点关注多年期的纵向研究（见在线补充资料）。
迄今为止，仅有少数预测指标和生物标志物可用于预测长期病程进展。尚无任何一项经过充分研究可用于临床。对患者进行适当的药物和心理治疗对于避免疾病复发至关重要。
双相情感障碍的长期病程高度异质性且多方面。尽管进行了深入研究，但尚未确定能够可靠预测临床病程的预测指标。这使得进一步研究尤为重要，以便提供个性化治疗方案、开发新疗法并在疾病早期对病程产生积极影响。
