The Hypomania Checklist (HCL-32): its factorial structure and association to indices of impairment in German and Swedish nonclinical samples

Meyer, Thomas D.; Hammelstein, Philipp; Nilsson, Lars Göran; Skeppar, Peter; Adolfsson, Rolf; Angst, Jules

doi:10.1016/j.comppsych.2006.07.001

Cited by 80 publications

(84 citation statements)

References 37 publications

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“…It is also unlikely that false positives would occur differentially for different tertiles of IL-6 or CRP, or by asthma/eczema diagnosis. Prevalence estimates of hypomania in non-clinical samples using this format of HCL-32 also appear to be comparable with bipolar disorder prevalence in other sources (Meyer et al 2007). Clinical verification of hypomania and information on bipolar disorder diagnoses would strengthen our conclusions, but it is likely that a number of individuals with hypomania symptoms will progress to a diagnosis and these symptoms are associated with a range of adverse psychiatric outcomes (Zimmermann et al 2009;Päären et al 2014).…”

Section: Potential Limitationssupporting

confidence: 64%

“…Overall, this definition of hypomanic symptoms, which includes severity, impairment and duration criteria, is more conservative than several other studies, which have tended to use only the threshold score of 14 (Hardoy et al 2005;Meyer et al 2007Meyer et al , 2014. We chose a duration criterion of 2-3 days or more because the 4-day threshold within the Diagnostic and Statistical Manual of Mental Disorders (DSM) excludes many individuals with bipolar disorder type II (Goldberg et al 2009;Bauer et al 2011;Parker et al 2014), and because 2 days is known to be the modal duration of hypomania in bipolar II disorder (Benazzi, 2001;Angst & Cassano, 2005).…”

Section: Assessment Of Hypomanic Symptomsmentioning

confidence: 97%

“…The HCL-32 has been used as both a continuous and categorical measure of hypomanic symptoms (Court et al 2014;Carvalho et al 2015). Although initially developed as a screening instrument for use in people diagnosed with depressive disorders, it is also a sensitive screening tool in non-clinical settings (Meyer et al 2007).…”

Section: Assessment Of Hypomanic Symptomsmentioning

confidence: 99%

“…We chose a duration criterion of 2-3 days or more because the 4-day threshold within the Diagnostic and Statistical Manual of Mental Disorders (DSM) excludes many individuals with bipolar disorder type II (Goldberg et al 2009;Bauer et al 2011;Parker et al 2014), and because 2 days is known to be the modal duration of hypomania in bipolar II disorder (Benazzi, 2001;Angst & Cassano, 2005). Based on previous work in non-clinical samples, we expected 5-10% of respondents to satisfy our criteria for features of hypomania (Meyer et al 2007;Holtmann et al 2009). Hypomanic symptoms were not clinically verified in the cohort.…”

Section: Assessment Of Hypomanic Symptomsmentioning

confidence: 99%

“…However, this instrument is well validated in clinical young adult population groups as a screening tool for bipolar disorder (Meyer et al 2007). There have not yet been sensitivity and specificity tests of the HCL-32 as a categorical measure which includes duration and impact on functioning.…”

Section: Potential Limitationsmentioning

confidence: 99%

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Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Hayes¹,

Khandaker²,

Anderson³

et al. 2017

Psychol. Med.

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Background. There are no existing longitudinal studies of inflammatory markers and atopic disorders in childhood and risk of hypomanic symptoms in adulthood. This study examined if childhood: (1) serum interleukin-6 (IL-6) and C-reactive protein (CRP); and (2) asthma and/or eczema are associated with features of hypomania in young adulthood.Method. Participants in the Avon Longitudinal Study of Parents and Children, a prospective general population UK birth cohort, had non-fasting blood samples for IL-6 and CRP measurement at the age of 9 years (n = 4645), and parents answered a question about doctor-diagnosed atopic illness before the age of 10 years (n = 7809). These participants completed the Hypomania Checklist at age 22 years (n = 3361).Results. After adjusting for age, sex, ethnicity, socio-economic status, past psychological and behavioural problems, body mass index and maternal postnatal depression, participants in the top third of IL-6 values at 9 years, compared with the bottom third, had an increased risk of hypomanic symptoms by age 22 years [adjusted odds ratio 1.77, 95% confidence interval (CI) 1.10-2.85, p < 0.001]. Higher IL-6 levels in childhood were associated with adult hypomania features in a dose-response fashion. After further adjustment for depression at the age of 18 years this association remained (adjusted odds ratio 1.70, 95% CI 1.03-2.81, p = 0.038). There was no evidence of an association of hypomanic symptoms with CRP levels, asthma or eczema in childhood.Conclusions. Higher levels of systemic inflammatory marker IL-6 in childhood were associated with hypomanic symptoms in young adulthood, suggesting that inflammation may play a role in the pathophysiology of mania. Inflammatory pathways may be suitable targets for the prevention and intervention for bipolar disorder.

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Section: Potential Limitationssupporting

confidence: 64%

Section: Assessment Of Hypomanic Symptomsmentioning

confidence: 97%

Section: Assessment Of Hypomanic Symptomsmentioning

confidence: 99%

Section: Assessment Of Hypomanic Symptomsmentioning

confidence: 99%

Section: Potential Limitationsmentioning

confidence: 99%

See 3 more Smart Citations

Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Hayes¹,

Khandaker²,

Anderson³

et al. 2017

Psychol. Med.

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Hypomania: a transcultural perspective

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Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions

McIntyre,

Alsuwaidan,

Baune

et al. 2023

World Psychiatry

119

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Treatment‐resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision‐making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition hampers precise estimates of the prevalence of TRD, and also belies efforts to identify risk factors, prevention opportunities, and effective interventions. In addition, it results in heterogeneity in clinical practice decision‐making, adversely affecting quality of care. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have adopted the most used definition of TRD (i.e., inadequate response to a minimum of two antidepressants despite adequacy of the treatment trial and adherence to treatment). It is currently estimated that at least 30% of persons with depression meet this definition. A significant percentage of persons with TRD are actually pseudo‐resistant (e.g., due to inadequacy of treatment trials or non‐adherence to treatment). Although multiple sociodemographic, clinical, treatment and contextual factors are known to negatively moderate response in persons with depression, very few factors are regarded as predictive of non‐response across multiple modalities of treatment. Intravenous ketamine and intranasal esketamine (co‐administered with an antidepressant) are established as efficacious in the management of TRD. Some second‐generation antipsychotics (e.g., aripiprazole, brexpiprazole, cariprazine, quetiapine XR) are proven effective as adjunctive treatments to antidepressants in partial responders, but only the olanzapine‐fluoxetine combination has been studied in FDA‐defined TRD. Repetitive transcranial magnetic stimulation (TMS) is established as effective and FDA‐approved for individuals with TRD, with accelerated theta‐burst TMS also recently showing efficacy. Electroconvulsive therapy is regarded as an effective acute and maintenance intervention in TRD, with preliminary evidence suggesting non‐inferiority to acute intravenous ketamine. Evidence for extending antidepressant trial, medication switching and combining antidepressants is mixed. Manual‐based psychotherapies are not established as efficacious on their own in TRD, but offer significant symptomatic relief when added to conventional antidepressants. Digital therapeutics are under study and represent a potential future clinical vista in this population.

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The Hypomania Checklist (HCL-32): its factorial structure and association to indices of impairment in German and Swedish nonclinical samples

Cited by 80 publications

References 37 publications

Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Childhood interleukin-6, C-reactive protein and atopic disorders as risk factors for hypomanic symptoms in young adulthood: a longitudinal birth cohort study

Hypomania: a transcultural perspective

Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions

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