Yuan-Yuan Wang1, Yuan Feng2, Dan-Dan Xu3, Wei Huang4, Ines H I Chow1, Chee H Ng5, Gabor S Ungvari6, Zhen Yuan1, Gang Wang7, Yu-Tao Xiang8. 1. Faculty of Health Sciences, University of Macau, Macau. 2. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China. 3. Faculty of Health Sciences, University of Macau, Macau; Faculty of science, Harbin University, Heilongjiang province, China. 4. Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China. 5. Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. 6. University of Notre Dame Australia/Graylands Hospital, Perth, Australia. 7. The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China. Electronic address: gangwangdoc@gmail.com. 8. Faculty of science, Harbin University, Heilongjiang province, China. Electronic address: xyutly@gmail.com.
Abstract
BACKGROUND: 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. METHOD: 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). RESULTS: 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. CONCLUSION: 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.
BACKGROUND: 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. METHOD: 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). RESULTS: 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. CONCLUSION: 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.