Hypomanic symptoms assessed by the HCL-32 in patients with major depressive disorder: A multicenter trial across China

• Published in: Journal of affective disorders 2012-12, Vol.143 (1), p.203-207
• Main Authors: Yang, Hai-Chen, Xiang, Yu-Tao, Liu, Tie-Bang, Han, Rong, Wang, Gang, Hu, Chen, Li, Ling-Jiang, Wang, Xiao-Ping, Peng, Hong-Jun, Si, Tian-Mei, Fang, Yi-Ru, Yuan, Cheng-Mei, Lu, Zheng, Hu, Jian, Chen, Zhi-Yu, Huang, Yi, Sun, Jing, Li, Hui-Chun, Zhang, Jin-Bei, Angst, Jules
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Affect; Biological and medical sciences; Bipolar affective disorder; Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - psychology; Bipolar disorders; Checklist; China; Depression; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - psychology; Depressive personality disorders; Diagnostic and Statistical Manual of Mental Disorders; Female; HCL-32; Humans; Hypomania; Major depressive disorder; Male; Medical sciences; Middle Aged; Mood disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; ROC Curve; Screening; Sensitivity and Specificity; Symptoms
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2012.06.002

Abstract Aim To investigate the results of the Hypomania Checklist-32 (HCL-32) administered as a screening instrument in clinical settings to mood disorders patients in the depressive phase. Methods A total of 1487 patients diagnosed and being treated for major depressive disorder (MDD) in 13 mental health centers across China were self-rated by the HCL-32 and independently examined by the Mini International Neuropsychiatric Interview (MINI). Results After examination by the MINI, 309 (20.8%) of the 1487 patients clinically diagnosed as having MDD satisfied DSM-IV criteria for bipolar disorder (BD): 118 (7.9%) for bipolar I disorder (BD-I) and 191 (12.8%) for bipolar II disorder (BD-II). The mean HCL-32 score of the BD patients was statistically higher than that of patients with unipolar depression (UD, major depressive disorder), BD-II higher than UD, while no significant difference between BD-I and BD-II. The HCL-32 distinguished between BD and UD (best cutoff score 14), between BD-II and UD (best cutoff 12). At the optimum cutoff of 12 between BD and UD, the sensitivity was 0.86, specificity 0.69. Limitations No standardized instruments were used to measure the severity of depressive symptoms. Depressed patients with a previous history of BD were excluded from this study. Conclusions The HCL-32 results in this multicenter study of patients in the depressive phase were similar to those of earlier, generally smaller-scale studies which subjects could be in any mood phases. A score of 12 could be used as the optimum cutoff between BD and UD to improve screening for BD-II if the HCL-32 was applied in clinical settings in China.