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Identifying hypomanic features in major depressive disorder using the hypomania checklist (HCL-32).
J Affect Disord. 2009 Apr; 114(1-3):68-73.JA

Abstract

BACKGROUND

Recent studies have challenged the traditional unipolar/bipolar divide with increasing support for a more dimensional view of affective disorders. We here examine the occurrence of hypomanic symptoms in individuals with a history of major depression selected to exclude indicators of underlying bipolarity.

METHODS

The presence of hypomanic symptoms was assessed by the Hypomania Checklist (HCL-32) self-report questionnaire in a sample of almost 600 patients meeting DSM-IV criteria for Bipolar I disorder (BPI N=260) or Major Recurrent Depressive disorder (MDDR N=322). Subjects were recruited and assessed using consistent, robust methodology.

RESULTS

We found that a score of 20 or more on the HCL-32 yielded the best combination of sensitivity (68%) and specificity (83%) to distinguish between BPI and MDDR. Within our highly selected and well defined MDDR sample (for which exclusion criteria included personal or family histories of bipolar or psychotic illness), 17% of MDDR subjects scored over the threshold of 20 on the HCL-32.

CONCLUSIONS

The HCL-32 identified a substantial number of patients meeting DSM-IV criteria for recurrent major depression (even when selected to exclude personal and family histories of bipolar illness) who reported bipolar symptoms at a level similar to that reported by patients meeting diagnostic criteria for bipolar disorder. This demonstrates the limitations of using DSM-IV criteria to distinguish those with and without bipolar features of illness.

Authors+Show Affiliations

Department of Psychological Medicine, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, CF14 4XN, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18760487

Citation

Forty, Liz, et al. "Identifying Hypomanic Features in Major Depressive Disorder Using the Hypomania Checklist (HCL-32)." Journal of Affective Disorders, vol. 114, no. 1-3, 2009, pp. 68-73.
Forty L, Smith D, Jones L, et al. Identifying hypomanic features in major depressive disorder using the hypomania checklist (HCL-32). J Affect Disord. 2009;114(1-3):68-73.
Forty, L., Smith, D., Jones, L., Jones, I., Caesar, S., Fraser, C., Gordon-Smith, K., & Craddock, N. (2009). Identifying hypomanic features in major depressive disorder using the hypomania checklist (HCL-32). Journal of Affective Disorders, 114(1-3), 68-73. https://doi.org/10.1016/j.jad.2008.07.017
Forty L, et al. Identifying Hypomanic Features in Major Depressive Disorder Using the Hypomania Checklist (HCL-32). J Affect Disord. 2009;114(1-3):68-73. PubMed PMID: 18760487.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identifying hypomanic features in major depressive disorder using the hypomania checklist (HCL-32). AU - Forty,Liz, AU - Smith,Daniel, AU - Jones,Lisa, AU - Jones,Ian, AU - Caesar,Sian, AU - Fraser,Christine, AU - Gordon-Smith,Katherine, AU - Craddock,Nick, Y1 - 2008/08/29/ PY - 2008/06/14/received PY - 2008/07/23/revised PY - 2008/07/23/accepted PY - 2008/9/2/pubmed PY - 2009/7/23/medline PY - 2008/9/2/entrez SP - 68 EP - 73 JF - Journal of affective disorders JO - J Affect Disord VL - 114 IS - 1-3 N2 - BACKGROUND: Recent studies have challenged the traditional unipolar/bipolar divide with increasing support for a more dimensional view of affective disorders. We here examine the occurrence of hypomanic symptoms in individuals with a history of major depression selected to exclude indicators of underlying bipolarity. METHODS: The presence of hypomanic symptoms was assessed by the Hypomania Checklist (HCL-32) self-report questionnaire in a sample of almost 600 patients meeting DSM-IV criteria for Bipolar I disorder (BPI N=260) or Major Recurrent Depressive disorder (MDDR N=322). Subjects were recruited and assessed using consistent, robust methodology. RESULTS: We found that a score of 20 or more on the HCL-32 yielded the best combination of sensitivity (68%) and specificity (83%) to distinguish between BPI and MDDR. Within our highly selected and well defined MDDR sample (for which exclusion criteria included personal or family histories of bipolar or psychotic illness), 17% of MDDR subjects scored over the threshold of 20 on the HCL-32. CONCLUSIONS: The HCL-32 identified a substantial number of patients meeting DSM-IV criteria for recurrent major depression (even when selected to exclude personal and family histories of bipolar illness) who reported bipolar symptoms at a level similar to that reported by patients meeting diagnostic criteria for bipolar disorder. This demonstrates the limitations of using DSM-IV criteria to distinguish those with and without bipolar features of illness. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/18760487/Identifying_hypomanic_features_in_major_depressive_disorder_using_the_hypomania_checklist__HCL_32__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(08)00316-9 DB - PRIME DP - Unbound Medicine ER -