The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients.

Zurich University Psychiatric Hospital, Lenggstrasse 31, P.O. Box 1931, 8032 Zurich, Switzerland.
Journal of Affective Disorders (Impact Factor: 3.71). 11/2005; 88(2):217-33. DOI: 10.1016/j.jad.2005.05.011
Source: PubMed

ABSTRACT Bipolar disorders (BP) are frequently diagnosed and treated as pure depression initially; accurate diagnosis often being delayed by 8 to 10 years. In prospective studies, the presence of hypomanic symptoms in adolescence is strongly predictive of later bipolar disorders. As such, an instrument for self-assessment of hypomanic symptoms might increase the detection of suspected and of manifest, but under-treated, cases of bipolar disorders.
The multi-lingual hypomania checklist (HCL-32) has been developed and is being tested internationally. This preliminary paper reports the performance of the scale in distinguishing individuals with BP (N=266) from those with major depressive disorder (MDD; N=160). The samples were adult psychiatry patients recruited in Italy (N=186) and Sweden (N=240).
The samples reported similar clinical profiles and the structure for the HCL-32 demonstrated two main factors identified as "active/elated" hypomania and "risk-taking/irritable" hypomania. The HCL-32 distinguished between BP and MDD with a sensitivity of 80% and a specificity of 51%.
Although the HCL-32 is a sensitive instrument for hypomanic symptoms, it does not distinguish between BP-I and BP-II disorders.
Future studies should test if different combinations of items, possibly recording the consequences of hypomania, can distinguish between these BP subtypes.

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Available from: Alex Gamma, Apr 03, 2015
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