[Is it all bipolar? Differential diagnosis of mood swings in young adulthood].

IF 1.1 4区医学 Q4 CLINICAL NEUROLOGY

Nervenarzt Pub Date : 2026-04-15 DOI:10.1007/s00115-026-01970-7

Matthias Nieberler, Miriam Appel, Catherina Klüpfel, Wiebke Warrings, Sarah Kittel-Schneider

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引用次数: 0

Abstract

Background: Mood swings can represent a key symptom of various psychiatric disorders in young adulthood. Due to substantial symptom overlap, clinicians often face diagnostic uncertainty, increasing the risk of misdiagnosis and inappropriate treatment.

Objectives: Description of qualitative and quantitative characteristics of mood swings in the most relevant psychiatric disorders.

Materials and methods: Narrative review based on the International Classification of Diseases, 11th Revision (ICD-11) and pertinent literature.

Results: Bipolar affective disorders exhibit episodic, mostly non-reactive mood swings in clearly defined temporary episodes. In unipolar depression, affective changes are predominantly downward-directed and may show diurnal variation. Emotionally unstable personality disorder is characterized by high-frequency, reactive, and interpersonally triggered affective states, whereas neurodevelopmental disorders typically present with situationally induced, short-lived emotional dysregulation.

Conclusions: Differential diagnostic evaluation requires a comprehensive clinical assessment, possibly supported by life charts, mood diaries, or psychometric instruments. Given the frequent comorbidities and symptom overlap, a longitudinal diagnostic approach is recommended in cases of uncertainty.

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都是躁郁症吗？青年期情绪波动的鉴别诊断[j]。

背景：情绪波动可以代表青年时期各种精神疾病的一个关键症状。由于大量的症状重叠，临床医生往往面临诊断的不确定性，增加了误诊和治疗不当的风险。目的：描述最相关精神疾病中情绪波动的定性和定量特征。材料和方法：以《国际疾病分类》第11版（ICD-11）和相关文献为基础进行叙述性综述。结果：双相情感障碍在明确定义的暂时性发作中表现为发作性，主要是非反应性情绪波动。在单极抑郁症中，情感变化主要是向下导向的，并可能表现出日变化。情绪不稳定型人格障碍的特征是高频、反应性和人际间触发的情感状态，而神经发育障碍通常表现为情境诱导的、短暂的情绪失调。结论：鉴别诊断评估需要全面的临床评估，可能需要生活图表、情绪日记或心理测量工具的支持。鉴于常见的合并症和症状重叠，在不确定的情况下，建议采用纵向诊断方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nervenarzt 医学-精神病学

CiteScore

2.50

自引率

18.20%

发文量

169

审稿时长

4-8 weeks

期刊介绍： Der Nervenarzt is an internationally recognized journal addressing neurologists and psychiatrists working in clinical or practical environments. Essential findings and current information from neurology, psychiatry as well as neuropathology, neurosurgery up to psychotherapy are presented. Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of neurology and psychiatry. Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.