Meyer Thomas D, Hammelstein Philipp, Nilsson Lars-Göran, Skeppar Peter, Adolfsson Rolf, Angst Jules
Department of Psychology, University of Tübingen, Germany.
Compr Psychiatry. 2007 Jan-Feb;48(1):79-87. doi: 10.1016/j.comppsych.2006.07.001. Epub 2006 Sep 6.
Bipolar disorders are often not recognized. Several instruments were developed but none primarily focused on hypomania. The Hypomania Checklist (HCL) is aimed at the identification of bipolarity in outpatients. Using a German and Swedish sample, we investigated if the factor structure in nonclinical samples is similar to the one reported for outpatient samples. Furthermore, we tested if people who probably had a lifetime history of hypomania report more depression or other signs of impairment and if current depression is associated with lifetime hypomania.
In the German study, participants completed the HCL-32 as an online questionnaire that also included questions about lifetime and current depression (n = 695), whereas the Swedish data relied on the paper-and-pencil version of the HCL-32 completed by a random sample from a representative population sample (n = 408).
The factor structure of the HCL-32 was fairly similar in both samples and to the ones presented by Angst et al (J Affect Disord 2005;88:217-33). People reporting "highs" (> or =4 days and experiencing negative consequences) not only endorsed more HCL-32 symptoms but also had higher rates of current and former depression and psychotherapy. Level of current depression was also associated with lifetime hypomanic symptoms. DISCUSSION AND LIMITATION: An "active-elated" and "risk-taking/irritable" factor of hypomania can be distinguished with the HCL-32 in clinical and nonclinical samples. Based on our results, the HCL-32 might even be useful as screening tool in nonclinical samples and not only in depressed outpatients. However, our data do not allow estimating sensitivity and specificity of the HCL-32 because structured clinical interviews were not included.
双相情感障碍常常未被识别。已开发了多种工具，但没有一种主要针对轻躁狂。轻躁狂检查表（HCL）旨在识别门诊患者中的双相情感障碍。我们使用德国和瑞典的样本，研究了非临床样本中的因子结构是否与门诊样本中报告的结构相似。此外，我们测试了可能有终生轻躁狂病史的人是否报告更多抑郁或其他损害迹象，以及当前抑郁是否与终生轻躁狂相关。
在德国的研究中，参与者通过在线问卷完成HCL - 32，问卷还包括有关终生和当前抑郁的问题（n = 695），而瑞典的数据则依赖于从代表性人群样本中随机抽取的样本以纸笔形式完成的HCL - 32（n = 408）。
两个样本中HCL - 32的因子结构相当相似，并且与Angst等人提出的结构相似（《情感障碍杂志》2005年；88：217 - 33）。报告有“情绪高涨”（≥4天且有负面后果）的人不仅认可更多HCL - 32症状，而且当前和既往抑郁及心理治疗的发生率更高。当前抑郁水平也与终生轻躁狂症状相关。
使用HCL - 32可在临床和非临床样本中区分轻躁狂的“积极欣快”和“冒险/易怒”因子。根据我们的结果，HCL - 32甚至可能作为非临床样本中的筛查工具有用，而不仅适用于抑郁门诊患者。然而，我们的数据不允许估计HCL - 32的敏感性和特异性，因为未纳入结构化临床访谈。
