Yang Yuan, Zhang Wu-Yang, Zhang Yao, Li Shuying, Cheung Teris, Zhang Dexing, Jackson Todd, He Fan, Xiang Yu-Tao
Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.
Department of Pediatric Development and Behavior, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Psychiatry. 2022 Apr 18;13:844699. doi: 10.3389/fpsyt.2022.844699. eCollection 2022.
Bipolar disorders (BD) are severe mental illnesses that are often misdiagnosed or under-diagnosed. The self-report 33-item Hypomania Checklist (HCL-33) and the 33-item Hypomania Checklist - external assessment (HCL-33-EA) are well-validated scales for BD symptom detection. This study compared the network structure, central symptoms, and network stability of hypomanic symptoms measured by the HCL-33 vs. the HCL-33-EA.
This cross-sectional study was conducted from January to December 2019. Adolescents (aged between 12 and 18 years) with BD were recruited from the outpatient department of Child Psychiatry, First Affiliated Hospital of Zhengzhou University. All participants were asked to complete the HCL-33, and their caregivers completed the HCL-33-EA. Network analyses were conducted.
A total of 215 adolescents with BD and their family caregivers were recruited. Node HCL17 ("talk more," node strength = 4.044) was the most central symptom in the HCL-33 network, followed by node HCL2 ("more energetic," node strength = 3.822), and HCL18 ("think faster," node strength = 3.801). For the HCL-33-EA network model, node HCL27 ("more optimistic," node strength = 3.867) was the most central node, followed by node HCL18 ("think faster," node strength = 3.077), and HCL17 ("talk more," node strength = 2.998). In the network comparison test, there was no significant difference at the levels of network structure ( = 0.946, = 0.931), global strength (S: 5.174, = 0.274), or each specific edge (all 's > 0.05 after Holm-Bonferroni corrections) between HCL-33 and HCL-33-EA items. Network stabilities for both models were acceptable.
The nodes "talk more" and "think faster" acted as central symptoms in BD symptom network models based on the HCL-33 and HCL-33-EA. Although the most prominent central symptom differed between the two models ("talk more" in HCL-33 vs. "more optimistic" in HCL-33-EA model), networks based on each measure were highly similar and underscored similarities in BD symptom relations perceived by adolescents and their caregivers. This research provides foundations for future studies with larger sample sizes toward improving the accuracy and robustness of observed network structures.
双相情感障碍（BD）是严重的精神疾病，常被误诊或漏诊。33项轻躁狂自评量表（HCL - 33）和33项轻躁狂他评量表（HCL - 33 - EA）是用于检测BD症状的经过充分验证的量表。本研究比较了HCL - 33和HCL - 33 - EA所测量的轻躁狂症状的网络结构、核心症状及网络稳定性。
本横断面研究于2019年1月至12月进行。从郑州大学第一附属医院儿童精神科门诊招募了年龄在12至18岁之间的BD青少年。所有参与者均被要求完成HCL - 33，其照料者完成HCL - 33 - EA。进行了网络分析。
共招募了215名BD青少年及其家庭照料者。在HCL - 33网络中，节点HCL17（“话多”，节点强度 = 4.044）是最核心的症状，其次是节点HCL2（“精力更充沛”，节点强度 = 3.822）和HCL18（“思维更快”，节点强度 = 3.801）。对于HCL - 33 - EA网络模型，节点HCL27（“更乐观”，节点强度 = 3.867）是最核心的节点，其次是节点HCL18（“思维更快”，节点强度 = 3.077）和HCL17（“话多”，节点强度 = 2.998）。在网络比较测试中，HCL - 33和HCL - 33 - EA项目在网络结构水平（ = 0.946， = 0.931）、全局强度（S：5.174， = 0.274）或各特定边（Holm - Bonferroni校正后所有的P值均>0.05）方面均无显著差异。两个模型的网络稳定性均可接受。
“话多”和“思维更快”这两个节点在基于HCL - 33和HCL - 33 - EA的BD症状网络模型中作为核心症状。尽管两个模型中最突出的核心症状有所不同（HCL - 33中为“话多”，HCL - 33 - EA模型中为“更乐观”），但基于每种测量方法的网络高度相似，强调了青少年及其照料者所感知的BD症状关系的相似性。本研究为未来更大样本量的研究奠定了基础，以提高观察到的网络结构的准确性和稳健性。
