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

Angst, Jules; Adolfsson, Rolf; Benazzi, Franco; Gamma, Alex; Hantouche, Elie G.; Meyer, Thomas D.; Skeppar, Peter; Vieta, Eduard; Scott, Jan

doi:10.1016/j.jad.2005.05.011

Cited by 594 publications

(533 citation statements)

References 33 publications

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“…The factor structure resembled that obtained for other samples of non-clinical subjects and patients with affective disorders in previous studies. 11,20,22 Individuals with BD had the highest HCL-32 VB scores. The mean number of affirmative responses to the list of symptoms was significantly different according to diagnosis.…”

Section: Translation and Adaptationmentioning

confidence: 98%

“…It is a self-applied questionnaire for the assessment of hypomania that investigates the presence of a variety of symptoms. 11 Participants are requested to focus on ''the 'high' periods'' and to indicate whether specific thoughts or emotions were present during this state (including low-threshold symptoms such as ''making jokes'' and ''I am less shy and inhibited'' or ''I am more flirtatious and/or am sexually more active''). In addition, the HCL-32 includes 8 severity and functional impact items related to the duration of the episodes and to positive and negative consequences across different areas.…”

Section: Instrumentsmentioning

confidence: 99%

“…10 Because hypomania is often not perceived by patients as pathological, it is not common for them to spontaneously report it to clinicians. 11 Furthermore, clinicians often do not directly inquire about hypomania if patients are seen during episodes of depression, 12 despite evidence showing that from 30% to 60% of outpatients with BD are initially considered to be unipolar. 13 This is of great importance, since the long term outcome of BD can be modified by early identification and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…A secondary goal is the development of shorter multi-lingual versions with established cut-off scores for hypomania. 11 Accordingly, the aim of this study was to develop a Brazilian version of the HCL-32 (HCL-32 VB), as well as to describe its psychometric characteristics for use in the clinical practice. We also aimed to determine a threshold score with good sensitivity and specificity to detect hypomania.…”

Section: Introductionmentioning

confidence: 99%

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Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ)

Soares

Moreno

Moura

et al. 2010

Rev. Bras. Psiquiatr.

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Objective: Bipolar disorders are often not recognized and undertreated. The diagnosis of current or past episodes of hypomania is of importance in order to increase diagnostic certainty. The Hypomania Checklist-32 is a self-applied questionnaire aimed at recognizing these episodes. As part of the international collaborative effort to develop multi-lingual versions of the Hypomania Checklist-32, we aimed to validate the Brazilian version and to compare its psychometric properties with those of the Mood Disorder Questionnaire. Method: Adult outpatients with bipolar disorder I (n = 37), bipolar disorder II (n = 44) and major depressive disorder (n = 42) of a specialized mood disorder unit were diagnosed according to DSM-IV-TR using a modified version of the SCID. We analyzed the internal consistency and discriminative ability of the Hypomania Checklist-32 Brazilian version in relation to the Mood Disorder Questionnaire. Results: The internal consistency of the Brazilian Hypomania Checklist-32, analyzed using Cronbach's alpha coefficient, was 0.86. A score of 18 or higher in the Hypomania Checklist-32 Brazilian version distinguished between bipolar disorder and major depressive disorder, with a sensitivity of 0.75 and a specificity of 0.58, compared to 0.70 and 0.58, respectively, for the Mood Disorder Questionnaire (score ≥ 7). The Hypomania Checklist-32 Brazilian version showed a dual factor structure characterized by "active/elated" and "risk-taking/ irritable" items. Hence, the Hypomania Checklist-32 Brazilian version was found to have a higher sensitivity but the same specificity as the Mood Disorder Questionnaire. Conclusion: The Brazilian version of the Hypomania Checklist-32 has adequate psychometric properties and helps discriminating bipolar disorder from major depressive disorder (but not bipolar disorder I from bipolar disorder II) with good sensitivity and specificity indices, similar to those of the Mood Disorder Questionnaire. Resumo Objetivo: O transtorno bipolar muitas vezes não é reconhecido e deixa de ser tratado adequadamente. O diagnóstico de episódios atuais ou passados é importante, a fim de aumentar a certeza diagnóstica. O Questionário de Autoavaliação de Hipomania-32 é um questionário autoaplicável para o rastreamento desses episódios. Como parte do desenvolvimento em vários idiomas do Questionário de Autoavaliação de Hipomania-32, nós objetivamos validar a versão brasileira e comparar suas propriedades psicométricas com o Questionário de Transtornos do Humor. Método: Em uma unidade especializada em transtornos do humor foram selecionados pacientes ambulatoriais adultos com transtorno bipolar I (n = 37), transtorno bipolar II (N = 44) e transtorno depressivo maior (N = 42) de acordo com a DSM-IV-TR

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Section: Translation and Adaptationmentioning

confidence: 98%

Section: Instrumentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ)

Soares

Moreno

Moura

et al. 2010

Rev. Bras. Psiquiatr.

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“…2 days of hypomania vs. the arbitrary DSM-IV 4 days duration one) and the use of sensitive (yet acceptable in sensitivity) instruments (e.g. Hypomania Check-List 32-items -HCL-32) [51] may lead to a prompter recognition of sub-threshold "resistance" clusters (e.g. "depressive mixed states" -MDE + 2 hypomanic features) [52] following a bipolar diathesis.…”

Section: What If Trd Persists Despite Repetitive "Adequate" Trials Anmentioning

confidence: 99%

Current Nosology of Treatment Resistant Depression: A Controversy Resistant to Revision

Fornaro¹,

Giosue²

2010

CPEMH

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Treatment-Resistant Depression (TRD) represents a source of ongoing clinical and nosological controversy and confusion. While no univocal consensus on its definition and specific correlation with major mood disorders has been reached to date, a progressively greater number of evidences tend to suggest a revision of current clinical nosology. Since a better assessment of TRD should be considered mandatory in order to achieve the most appropriate clinical management, this narrative review aims to briefly present current most accepted definitions of the phenomenon, speculating on its putative bipolar diathesis for some of the cases originally assessed as unipolar depression.Keywords: Treatment Resistant Depression, Bipolar Disorder, Controversy. EPIDEMIOLOGY OF TRD Treatment-resistant depression (TRD) is a relatively common condition presenting with substantial challenges to both the clinician and researcher [1].In fact, despite a progressively higher number of available antidepressant therapies, TRD occurs frequently in clinical practice, and is associated with profound psychosocial disability, personal suffering and economic cost burden. Between one and two thirds of Major Depressive Disorder (MDD) patients will not respond to the first antidepressant prescribed and 15 to 33 percent will "resist" to multiple interventions, including non-pharmacological therapies [2].Increasing the burden associated with MDD, its high prevalence: World Health Organization (WHO) estimated that 5-10% of the population at any given time is suffering from identifiable depression needing psychiatric or psychosocial intervention, while the life-time risk of developing depression is 10-20% in females and slightly less in males [3]. [11] reported that approximately 22% of patients who received treatment for depression by their primary-care physicians remitted following 6 months of treatment, 32% were partial responders, while 45% were non-responders. Similarly, Rush and colleagues [8] reported an 11% remission rate and 26.3% response rate among depressed outpatients following 12 months of treatment of depression in one of several public-sector community clinics. Petersen and colleagues [6] report a 50.4% remission rate among outpatients with MDD enrolled in 1 of 2 hospital-based, academically affiliated depression specialty clinics (Massachusetts General Hospital, an affiliate of Harvard Medical School and Rhode Island Hospital, an affiliate of Brown University) following an average of 25.8 weeks of treatment. Finally, it is also worth noting that while partial or non-response are common, residual symptoms among remitters are also highly prevalent [12,13], being usually associated with poorer psychosocial functioning [14] as well as an increased relapse rates [15], higher suicidal ideation and attempts, higher number of lifetime hospitalizations, more frequent healthcare resources utilization, general practitioner consultation, job loss and social retirement [16]. ISSUES IN DEFINING TRD: A CLINICAL CONTRO-VERSY "RESISTANT TO RE...

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Prevalence and Characteristics of Undiagnosed Bipolar Disorders in Patients With a Major Depressive Episode

Angst

Azorin

Bowden³

et al. 2011

Arch Gen Psychiatry

369

265

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The bipolar-specifier criteria in comparison with DSM-IV-TR criteria were valid and identified an additional 31% of patients with major depressive episodes who scored positive on the bipolarity criteria. Family history, illness course, and clinical status, in addition to DSM-IV-TR criteria, may provide useful information for physicians when assessing evidence of bipolarity in patients with major depressive episodes. Such an assessment is recommended before deciding on treatment.

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

Cited by 594 publications

References 33 publications

Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ)

Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ)

Current Nosology of Treatment Resistant Depression: A Controversy Resistant to Revision

Prevalence and Characteristics of Undiagnosed Bipolar Disorders in Patients With a Major Depressive Episode

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