Faculty of Health Sciences, University of Macau, Macau.
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
J Affect Disord. 2018 Aug 1;235:206-210. doi: 10.1016/j.jad.2018.04.019. Epub 2018 Apr 3.
The misdiagnosis of bipolar disorder (BD) as major depressive disorder (MDD) is common in clinical practice and may result in inappropriate treatment. The 33-item Hypomania Checklist (HCL-33) is a newly developed screening scale for BD with satisfactory psychometric properties. In this study, a short version of the HCL-33 was developed and validated to discriminate between BD and MDD.
All interviews were conducted in a major psychiatric hospital in China. The short version of HCL-33 (the HCL-23) was initially developed using a sample of 186 patients (MDD = 84, BD-I = 46, BD-II = 56) and its performance was tested in a separate sample of 164 patients (MDD = 77, BD-I = 44, BD-II = 43).
The HCL-23 showed high internal consistency (Cronbach's alpha = 0.906) with two-factorial dimensions. Compared to the HCL-33, the HCL-23 demonstrated a marginally weaker performance in terms of sensitivity+specificity (1.38 vs 1.36 for BD vs MDD, 1.33 vs 1.32 for BD-I vs MDD, and 1.44 vs 1.42 for BD-II vs MDD). For discriminating BD, BD-I, and BD-II from MDD, the HCL-23 showed better sensitivity (0.82 vs 0.67, 0.77 vs 0.68, and 0.86 vs 0.72, respectively) than the HCL-33, while the HCL-33 showed better specificity (0.71 vs 0.55, 0.65 vs 0.55, and 0.71 vs 0.56, respectively) than the HCL-23.
Both HCL-33 and HCl-23 have comparable psychometric properties and screening ability for BD. The HCL-23 is an effective screening tool for detecting BD in clinical settings. The HCL-23 was developed in China, therefore its psychometric properties need to be confirmed in different socio-cultural contexts.
双相障碍（BD）误诊为重度抑郁症（MDD）在临床实践中很常见，可能导致治疗不当。新开发的 33 项轻躁狂清单（HCL-33）是一种用于 BD 的筛查量表，具有令人满意的心理测量特性。本研究旨在开发和验证 HCL-33 的简短版本，以区分 BD 和 MDD。
所有访谈均在中国一家主要精神病院进行。使用 186 例患者的样本（MDD=84，BD-I=46，BD-II=56）初步开发了 HCL-33 的简短版本（HCL-23），并在 164 例患者的独立样本中对其性能进行了测试（MDD=77，BD-I=44，BD-II=43）。
HCL-23 具有两个因子维度，内部一致性高（Cronbach's alpha=0.906）。与 HCL-33 相比，HCL-23 在敏感性+特异性方面表现稍差（BD 与 MDD 为 1.38 比 1.36，BD-I 与 MDD 为 1.33 比 1.32，BD-II 与 MDD 为 1.44 比 1.42）。对于将 BD、BD-I 和 BD-II 与 MDD 区分开来，HCL-23 的敏感性优于 HCL-33（分别为 0.82 比 0.67、0.77 比 0.68 和 0.86 比 0.72），而 HCL-33 的特异性优于 HCL-23（分别为 0.71 比 0.55、0.65 比 0.55 和 0.71 比 0.56）。
HCL-33 和 HCl-23 均具有可比的心理测量特性和 BD 筛查能力。HCL-23 是一种有效的临床检测 BD 的筛查工具。HCL-23 在中国开发，因此其心理测量特性需要在不同的社会文化背景下得到证实。
