Wang Yuan-Yuan, Feng Yuan, Fang Meng, Guo Chengwei, Ungvari Gabor S, Hall Brian J, Wang Gang, Xiang Yu-Tao
Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.
The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Front Psychiatry. 2021 Jun 22;12:518722. doi: 10.3389/fpsyt.2021.518722. eCollection 2021.
Bipolar disorder (BD) is a severe psychiatric disorder that is often misdiagnosed and under-diagnosed in clinical settings. The 33-item Hypomania Checklist (HCL-33) is a newly developed self-administered scale for BD detection, while the 33-item Hypomania Checklist-external assessment (HCL-33-EA) is a version of the HCL-33 for external rating used by patient's carer (e.g., family member or friend). We aimed to compare the screening abilities between the HCL-33 and the HCL-33-EA, and evaluate the screening consistency between the two scales. The data were collected from 269 patients with diagnosed BD ( = 84) or major depressive disorder (MDD) ( = 185). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) between the HCL-33 and the HCL-33-EA for BD were compared against clinician diagnosis as the gold standard. Using Youden's index, the optimal cut-off value of the HCL-33 is 20, while the corresponding figure for HCL-33-EA is 11. Using Youden's index, the HCL-33-EA showed a better performance than the HCL-33 (0.51 vs.0.41). The HCL-33-EA was more sensitive in correctly identifying BD patients from MDD patients than the HCL-33 (0.83 vs. 0.59), while the HCL-33 presented better specificity than the HCL-33-EA (0.82 vs. 0.68). There was significant screening consistency between the two scales ( < 0.001). Both scales have acceptable psychometric properties in detection BD from MDD. Use of the two scales should be considered based on the assessment purpose in clinical research or daily practice (i.e., prefer sensitivity or specificity). Noticeably, the current sample size is insufficient and future studies are recommended to further evaluate the scales.
双相情感障碍（BD）是一种严重的精神疾病，在临床环境中常常被误诊和漏诊。33项轻躁狂检查表（HCL - 33）是一种新开发的用于双相情感障碍检测的自我评估量表，而33项轻躁狂检查表外部评估版（HCL - 33 - EA）是供患者照顾者（如家庭成员或朋友）使用的用于外部评分的HCL - 33版本。我们旨在比较HCL - 33和HCL - 33 - EA的筛查能力，并评估这两种量表之间的筛查一致性。数据收集自269例已确诊双相情感障碍（n = 84）或重度抑郁症（MDD）（n = 185）的患者。以临床医生诊断作为金标准，比较了HCL - 33和HCL - 33 - EA对双相情感障碍的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC）。使用约登指数，HCL - 33的最佳截断值为20，而HCL - 33 - EA的相应值为11。使用约登指数，HCL - 33 - EA表现优于HCL - 33（0.51对0.41）。与HCL - 33相比，HCL - 33 - EA在从重度抑郁症患者中正确识别双相情感障碍患者方面更敏感（0.83对0.59），而HCL - 33的特异性优于HCL - 33 - EA（0.82对0.68）。两种量表之间存在显著的筛查一致性（P < 0.001）。在从重度抑郁症中检测双相情感障碍方面，两种量表都具有可接受的心理测量特性。在临床研究或日常实践中，应根据评估目的（即更倾向于敏感性或特异性）考虑使用这两种量表。值得注意的是，当前样本量不足，建议未来的研究进一步评估这两种量表。
