Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Bethesda, MD 20892, United States.
Ferkauf Graduate School, Yeshiva University, University in New York, 1165 Morris Park Ave, Bronx, New York 10461, United States.
Compr Psychiatry. 2018 Jul;84:7-14. doi: 10.1016/j.comppsych.2018.03.010. Epub 2018 Apr 3.
There is substantial evidence that bipolar disorder (BD) manifests on a spectrum rather than as a categorical condition. Detection of people with subthreshold manifestations of BD is therefore important. The Hypomania Checklist-32 (HCL-32) was developed as a tool to identify such people.
The aims of this paper were to: (1) investigate the factor structure of HCL-32; (2) determine whether the HCL-32 can discriminate between mood disorder subtypes; and (3) assess the familial aggregation and cross-aggregation of hypomanic symptoms assessed on the HCL with BD.
Ninety-six probands recruited from the community and 154 of their adult first-degree relatives completed the HCL-32. Diagnosis was based on semi-structured interviews and family history reports. Explanatory factor analysis and mixed effects linear regression models were used.
A four-factor ("Activity/Increased energy," "Distractibility/Irritability", "Novelty seeking/Disinhibition, "Substance use") solution fit the HCL-32, explaining 11.1% of the total variance. The Distractibility/Irritability score was elevated among those with BP-I and BP-II, compared to those with depression and no mood disorders. Higher HCL-32 scores were associated with increased risk of BD-I (OR = 1.22, 95%CI 1.14-1.30). The "Distractibility/Irritability" score was transmitted within families (β = 0.15, p = 0.040). However, there was no familial cross-aggregation between mood disorders and the 4 HCL factors.
Our findings suggest that the HCL-32 discriminates the mood disorder subtypes, is familial and may provide a dimensional index of propensity to BD. Future studies should explore the heritability of symptoms, rather than focusing on diagnoses.
有大量证据表明，双相情感障碍（BD）呈连续谱而非分类状态存在。因此，检测具有亚临床表现的 BD 患者很重要。Hypomania Checklist-32（HCL-32）是一种用于识别此类患者的工具。
本文旨在：（1）调查 HCL-32 的因子结构；（2）确定 HCL-32 是否可以区分心境障碍亚型；（3）评估 HCL 评估的轻躁狂症状与 BD 的家族聚集和交叉聚集。
从社区招募了 96 名先证者和他们的 154 名成年一级亲属完成了 HCL-32。诊断基于半结构式访谈和家族史报告。使用解释性因素分析和混合效应线性回归模型。
HCL-32 的四因子（“活动/增加的能量”、“注意力分散/易怒”、“寻求新奇/去抑制”、“物质使用”）解决方案，解释了总方差的 11.1%。与抑郁和无心境障碍者相比，BP-I 和 BP-II 患者的注意力分散/易怒评分较高。HCL-32 评分较高与 BD-I 的风险增加相关（OR=1.22，95%CI 1.14-1.30）。“注意力分散/易怒”评分在家庭中传递（β=0.15，p=0.040）。然而，心境障碍和 HCL 的 4 个因子之间没有家族交叉聚集。
我们的发现表明，HCL-32 可以区分心境障碍亚型，具有家族性，可能提供 BD 易感性的维度指数。未来的研究应该探索症状的遗传性，而不是专注于诊断。
