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与心境障碍问卷(MDQ)相比,巴西版轻躁狂清单(HCL-32)的信度和效度。

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

机构信息

Mood Disorders Unit, Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

Braz J Psychiatry. 2010 Dec;32(4):416-23. doi: 10.1590/s1516-44462010000400015.

Abstract

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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