Department of Psychiatry, University of Pisa, Pisa, Italy.
Psychopathology. 2012;45(6):390-8. doi: 10.1159/000338047. Epub 2012 Aug 7.
Although manic or hypomanic episodes define bipolar disorder (BD), most patients show a predominance of depressive symptomatology, often associated with delayed or disregarded BD diagnosis. The Hypomania Checklist-32 (HCL-32) has therefore been developed and tested internationally to facilitate BD recognition.
Five hundred seventy-one (563 eligible) patients diagnosed with a major depressive episode according to DSM-IV criteria were consecutively enrolled in a cross-sectional, multicenter, observational study (Come To Me). Lifetime manic or hypomanic features were assessed by the HCL-32, and severity of depressive and anxious symptomatology was assessed using the Zung's self-report questionnaires for depression and anxiety.
Among the patients diagnosed with BD (n = 119), either type I or type II, the occurrence of (hypo)manic symptoms was significantly higher compared to major depressive disorder (MDD) symptoms according to HCL-32 total and subscale scores obtained using a score of 14, which ensured an optimal discrimination between BD and MDD with a sensitivity of 0.85 and a specificity of 0.78.
Although some false positives might occur, the HCL-32 was confirmed to be a useful instrument in the detection of past hypomania in MDD patients, finally contributing to proper therapeutic choices.
尽管躁狂或轻躁狂发作定义了双相情感障碍（BD），但大多数患者表现出抑郁症状占主导地位，这常常与 BD 诊断的延迟或忽视有关。因此，国际上已经开发并测试了 Hypomania Checklist-32（HCL-32），以促进 BD 的识别。
根据 DSM-IV 标准诊断为重度抑郁发作的 571 名（563 名符合条件）患者连续纳入横断面、多中心、观察性研究（Come To Me）。使用 HCL-32 评估患者的终生躁狂或轻躁狂特征，使用 Zung 的自评抑郁和焦虑问卷评估抑郁和焦虑症状的严重程度。
在诊断为 BD（n = 119）的患者中，无论是 I 型还是 II 型，根据 HCL-32 总分和子量表评分，使用 14 分确保 BD 和 MDD 之间的最佳区分，敏感性为 0.85，特异性为 0.78，（轻）躁狂症状的发生明显高于 MDD 症状。
尽管可能会出现一些假阳性，但 HCL-32 被证实是一种在 MDD 患者中检测过去轻躁狂的有用工具，最终有助于做出适当的治疗选择。
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