Mood Disorders Unit, Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
Braz J Psychiatry. 2010 Dec;32(4):416-23. doi: 10.1590/s1516-44462010000400015.
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.
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.
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.
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.
双相情感障碍常被漏诊和治疗不足。识别当前或过去的轻躁狂发作对提高诊断的准确性非常重要。轻躁狂清单-32 是一种自我应用的问卷，旨在识别这些发作。作为开发轻躁狂清单-32 多语言版本的国际合作的一部分，我们旨在验证巴西版本，并比较其与心境障碍问卷的心理测量特性。
专门的心境障碍单位的成人门诊患者，包括单相躁狂症 I 型（n=37）、单相躁狂症 II 型（n=44）和重性抑郁症（n=42），根据 DSM-IV-TR 使用 SCID 的修改版进行诊断。我们分析了巴西版轻躁狂清单-32 的内部一致性和鉴别能力与心境障碍问卷的关系。
使用 Cronbach's alpha 系数分析，巴西版轻躁狂清单-32 的内部一致性为 0.86。巴西版轻躁狂清单-32 的得分在 18 或更高可区分双相情感障碍和重性抑郁症，其敏感性为 0.75，特异性为 0.58，而心境障碍问卷分别为 0.70 和 0.58（得分>7）。巴西版轻躁狂清单-32 显示出双因素结构，特征为“活跃/高兴”和“冒险/易怒”项目。因此，巴西版轻躁狂清单-32 的敏感性较高，但特异性与心境障碍问卷相同。
巴西版轻躁狂清单-32 具有足够的心理测量特性，有助于区分双相情感障碍和重性抑郁症（但不能区分单相躁狂症 I 型和单相躁狂症 II 型），具有良好的敏感性和特异性指数，与心境障碍问卷相似。
