The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China.
Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
J Geriatr Psychiatry Neurol. 2022 May;35(3):410-417. doi: 10.1177/08919887211016065. Epub 2021 May 28.
Bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD) in older patients. This study examined the psychometric properties of the 33-item Hypomania Checklist (HCL-33) and its accuracy to differentiate BD from MDD among older adults.
A total of 215 depressed older patients were recruited; 107 were diagnosed with BD (71 with BD-type I and 36 with BD-type II) and 108 with MDD. Principal components analysis (PCA) was used to explore the factor structure of the HCL-33. Cronbach's alpha was calculated to test the internal consistency. Intra-class correlation coefficient (ICC) was used to measure test-retest reliability. The receiver operating characteristic (ROC) analysis was used to generate the optimal cut-off value to differentiate between BD and MDD.
Two factors were identified in the PCA analysis accounting for 33.9% of the total variance. The Cronbach's alpha value for the HCL-33 was 0.912, with 0.922 for factor I and 0.664 for factor II. The test-retest reliability was excellent (ICC: 0.891). The optimal cut-off of the HCL-33 total score for discriminating between MDD and BD was 14, with a sensitivity of 88.8% and specificity of 82.4%.
The HCL-33 had satisfactory reliability and validity and could be used to distinguish BD from MDD in older adults.
躁郁症（BD）在老年患者中常被误诊为重度抑郁症（MDD）。本研究旨在探讨 33 项轻躁狂清单（HCL-33）的心理计量特性及其在区分老年患者中 BD 与 MDD 的准确性。
共招募了 215 名抑郁的老年患者；其中 107 名被诊断为 BD（71 名 BD-型 I，36 名 BD-型 II），108 名被诊断为 MDD。采用主成分分析法（PCA）探讨 HCL-33 的因子结构。采用克朗巴赫 α系数检验内部一致性。采用组内相关系数（ICC）测量测试-再测试信度。采用受试者工作特征（ROC）分析生成区分 BD 和 MDD 的最佳截断值。
PCA 分析确定了两个因子，占总方差的 33.9%。HCL-33 的克朗巴赫 α 值为 0.912，因子 I 为 0.922，因子 II 为 0.664。测试-再测试信度极好（ICC：0.891）。HCL-33 总分区分 MDD 和 BD 的最佳截断值为 14，敏感度为 88.8%，特异性为 82.4%。
HCL-33 具有良好的信度和效度，可用于区分老年患者中的 BD 和 MDD。
