Identifying hypomanic features in major depressive disorder using the hypomania checklist (HCL-32)

Forty, L., Smith, D.J. , Jones, L., Jones, I., Caesar, S., Fraser, C., Gordon-Smith, K. and Craddock, N. (2009) Identifying hypomanic features in major depressive disorder using the hypomania checklist (HCL-32). Journal of Affective Disorders, 114(1-3), pp. 68-73. (doi:10.1016/j.jad.2008.07.017)

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Publisher's URL: http://dx.doi.org/10.1016/j.jad.2008.07.017

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Smith, Professor Daniel
Authors: Forty, L., Smith, D.J., Jones, L., Jones, I., Caesar, S., Fraser, C., Gordon-Smith, K., and Craddock, N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Journal Name:Journal of Affective Disorders
ISSN:0165-0327
ISSN (Online):1573-2517
Published Online:29 August 2008

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