Discriminative Hypomania Checklist-32 Factors in Unipolar and Bipolar Major Depressive Patients

Background: Although manic or hypomanic episodes define bipolar disorder (BD), most patients show a predominance of depressive symptomatology, often associated with delayed or disregarded BD diagnosis. The Hypomania Checklist-32 (HCL-32) has therefore been developed and tested internationally to fac...

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Bibliographic Details
Published in:Psychopathology 2012-01, Vol.45 (6), p.390-398
Main Authors: Perugi, Giulio, Fornaro, Michele, Maremmani, Icro, Canonico, Pier Luigi, Carbonatto, Paolo, Mencacci, Claudio, Muscettola, Giovanni, Pani, Luca, Torta, Riccardo, Vampini, Claudio, Parazzini, Fabio, Dumitriu, Arina, Angst, Jules
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Aged
Biological and medical sciences
Bipolar disorder
Bipolar Disorder - diagnosis
Bipolar disorders
Checklist - statistics & numerical data
Depression
Depressive Disorder, Major - diagnosis
Diagnosis, Differential
Female
Humans
Male
Medical sciences
Mental depression
Middle Aged
Mood disorders
Original Paper
Patients
Psychology. Psychoanalysis. Psychiatry
Psychometrics - instrumentation
Psychopathology. Psychiatry
Sensitivity and Specificity
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Summary:Background: Although manic or hypomanic episodes define bipolar disorder (BD), most patients show a predominance of depressive symptomatology, often associated with delayed or disregarded BD diagnosis. The Hypomania Checklist-32 (HCL-32) has therefore been developed and tested internationally to facilitate BD recognition. Sampling andMethods: Five hundred seventy-one (563 eligible) patients diagnosed with a major depressive episode according to DSM-IV criteria were consecutively enrolled in a cross-sectional, multicenter, observational study (Come To Me). Lifetime manic or hypomanic features were assessed by the HCL-32, and severity of depressive and anxious symptomatology was assessed using the Zung’s self-report questionnaires for depression and anxiety. Results: Among the patients diagnosed with BD (n = 119), either type I or type II, the occurrence of (hypo)manic symptoms was significantly higher compared to major depressive disorder (MDD) symptoms according to HCL-32 total and subscale scores obtained using a score of 14, which ensured an optimal discrimination between BD and MDD with a sensitivity of 0.85 and a specificity of 0.78. Conclusions: Although some false positives might occur, the HCL-32 was confirmed to be a useful instrument in the detection of past hypomania in MDD patients, finally contributing to proper therapeutic choices.
ISSN:0254-4962
1423-033X
DOI:10.1159/000338047