Screening for bipolar disorder: comparing the performance of the Hypomania Checklist (HCL-32) and the Bipolar Spectrum Diagnostic Scale (BSDS) in a UK sample

Smith, D., Forty, L., Barnes, E., Simpson, S. , Griths, E., Hood, K. and Craddock, N. (2009) Screening for bipolar disorder: comparing the performance of the Hypomania Checklist (HCL-32) and the Bipolar Spectrum Diagnostic Scale (BSDS) in a UK sample. Bipolar Disorders. Supplement, 11(Sup 1), pp. 81-82. (doi: 10.1111/j.1399-5618.2009.00695.x)

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Abstract

Introduction: Bipolar spectrum disorders are likely to be underdiagnosed in clinical practice. The need to improve their recognition and diagnosis has led to the development of several bipolar screening instruments, including the Mood Disorder Questionnaire (MDQ), the Hypomania Checklist (HCL-32) and the Bipolar Spectrum Diagnostic Scale (BSDS). The MDQ has been widely studied and appears to be most useful for confidently ruling out a bipolar diagnosis. To date, little is known about the usefulness of the HCL-32 and BSDS in the UK. The aim of this study was to compare the performance of the HCL-32 and BSDS in terms of correctly differentiating between bipolar spectrum disorders (including BP-I, BP-II and BP-NOS) and recurrent major depressive disorder (MDD) in a representative sample from the UK.<p></p> Methods: 53 patients with bipolar disorder (BP-I, BP-II and BPNOS) and 50 patients with recurrent MDD were recruited from Community Mental Health Teams and were assessed according to the Mini International Neuropsychiatric Interview (MINI). Subjects also completed a detailed structured clinical assessment and the HCL-32 and BSDS screening instruments. Receiver operating curve (ROC) analysis was used to calculate sensitivities, specificities, positive predictive values (PPV) and negative predictive values (NPV) for the HCL-32 and BSDS questionnaires.<p></p> Results: Both instruments performed very well. A HCL-32 score of 19 or more produced a sensitivity of 77.4%, specificity 78.0%, positive predictive value (PPV) 78.8% and negative predictive value (NPV) 76.5% (the area under the ROC curve, AUC, was 0.85). Similarly, a BSDS score of 16 or more produced a sensitivity of 75.5%, specificity 72.0%, PPV 74.1% and NPV 73.5% (AUC = 0.80).<p></p> Discussion: Although the HCL-32 performed slightly better than the BSDS, both of these instruments are promising for the correct detection of bipolar spectrum disorders in UK clinical practice. Future studies should assess their usefulness for screening in both primary and secondary care samples of depressed patients.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Simpson, Professor Sharon
Authors: Smith, D., Forty, L., Barnes, E., Simpson, S., Griths, E., Hood, K., and Craddock, N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Bipolar Disorders. Supplement
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1399-2406
ISSN (Online):1399-5618

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