Screening for hypomania among patients with recurrent depression using the new HCL-33 questionnaire
Suggested citation:
Mosolov SN, Yaltonskaya PA, Sen'ko OV, et al. [Screening for hypomania among patients with recurrent depression using the new HCL-33 questionnaire]. Rossiiskii psikhiatricheskii zhurnal [Russian Journal of Psychiatry]. 2021;(6):59-69. Russian
To validate the Russian version of the HCL-33 we studied the cohort of 150 patients with a current diagnosis of Recurrent Depressive Disorder. The diagnosis according to ICD-10 was reassessed by clinical examination and was verified with structured diagnostic interview. In 69 patients (46%) the diagnosis was changed to Bipolar disorder. A cut-off score of 16 was optimal for separating Bipolar disorder II and Recurrent depression with the best ratio of sensitivity (0.71) and specificity (0.69); the highest ROC AUC value was 0.773; Cronbach's alpha – 0.91. Analysis of main components reveals two-factor structure of the scale. Both external and internal versions of the questionnaire had good consistence and can be recommended for hypomania screening in patients with current depression.
Keywords bipolar disorder; recurrent depressive disorder; HCL-33; hypomania
1. Mosolov SN, Kostyukova EG, Kuzavkova MV. Bipolyarnoe affektivnoe rasstroistvo. Diagnostika i terapiya. Moscow: Medpress-inform; 2008. 383 p. (In Russ.) 2. Miller S, Dell'Osso B, Ketter TA. The prevalence and burden of bipolar depression. J Affect Disord. 2014;169(Suppl 1):S3–11. DOI: https://doi.org/10.1016/S0165-0327(14)70003-5; PMID: 25533912 3. Mosolov SN, Kostyukova EG. Bipolyarnoe rasstroistvo. In: Psikhiatriya: natsional'noe rukovodstvo. NG Neznanov, YuA Aleksandrovskij, editors. Moscow; 2018. p. 379–439. (In Russ.) 4. Solomon DA, Leon AC, Maser JD, et al. Distinguishing bipolar major depression from unipolar major depression with the screening assessment of depression-polarity (SAD-P). J Clin Psychiatry. 2006;67(3):434–42. DOI: https://doi.org/10.4088/JCP.v67n0315 5. Hirschfeld RM, Lewis L, Vornik LA. Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. J Clin Psychiatry. 2003;64(2):161–74. PMID: 12633125 6. Mosolov SN. Sravnitel'naya effektivnost' profilakticheskogo primeneniya karbonata litiya, karbamazepina, val'proata natriya pri affektivnykh i shizoaffektivnykh psikhozakh. Zh Nevropatol Psikhiatr Im SS Korsakova. 1991;(4):78–83. (In Russ.) 7. Kostyukova EG, Mosolov SN. Algoritm biologicheskoi terapii depressii pri bipolyarnom affektivnom rasstroistve. Sovremennaya terapiya psikhicheskikh rasstroistv. 2020;(4):36–45. (In Russ.) 8. Angst J, Azorin JM, Bowden CL, et al. Prevalence and characteristics of undiagnosed bipolar disorders in patients with a major depressive episode: The BRIDGE study. Arch Gen Psychiatry. 2011;68(8):791–8. DOI: https://doi.org/10.1001/archgenpsychiatry.2011.87 9. Mosolov SN, Ushkalova AV, Kostyukova EG, et al. Bipolar II disorder in patients with a current diagnosis of recurrent depression. Bipolar Disorders. 2014;16(4):389–99. DOI: https://doi.org/10.1111/bdi.12192 10. Lish JD, Dime-Meenan S, Whybrow PC, et al. The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members. J Affect Disord. 1994;31(4):281–94. DOI: https://doi.org/10.1016/0165-0327(94)90104-X 11. Coryell W, Endicott J, Maser JD, et al. Long-term stability of polarity distinctions in the affective disorders. Am J Psychiatry. 1995;152(3):385–90. DOI: https://doi.org/10.1176/ajp.152.3.385 12. Mosolov SN, Kostyukova EG. Diagnostika i terapiya rasstroistv bipolyarnogo spectra. In: Psikhiatriya: Kratkoe natsional'noe rukovodstvo. YuA Aleksandrovskij, NG Neznanov, editors. Moscow: GEOTAR-Media; 2021. p. 322–68. (In Russ.) 13. Angst J. The emerging epidemiology of hypomania and bipolar II disorder. J Affect Disord. 1998;50(2–3):143–51. DOI: https://doi.org/10.1016/S0165-0327(98)00142-6 14. Bowden CL. Strategies to reduce misdiagnosis of bipolar depression. Psychiatr Serv. 2001;52(1):51–5. DOI: https://doi.org/10.1176/appi.ps.52.1.51; PMID: 11141528 15. Angst J, Adolfsson R, Benazzi F, et al. The HCL-32: Towards a self-assessment tool for hypomanic symptoms in outpatients. J Affect Disord. 2005;88(2):217–33. DOI: https://doi.org/10.1016/j.jad.2005.05.011 16. Poon Y, Chung KF, Tso KC, et al. The use of Mood Disorder Questionnaire, Hypomania Checklist-32 and clinical predictors for screening previously unrecognised bipolar disorder in a general psychiatric setting. Psychiatry Res. 2012;195(3):111–7. DOI: https://doi.org/10.1016/j.psychres.2011.07.014 17. Bipolar Spectrum Diagnostic Scale (BSDS). 2013. URL: https://www.psychiatrictimes.com/view/bipolar-spectrum-diagnostic-scale-bsds (accessed on: 08.03.2020). 18. Kazakovtsev BA, Demcheva NK, Yazdovskaya AV, Sidoryuk OV. Psychiatric care for the population of the Russian Federation in 2017. Otv. red. ZI Kekelidze. Moscow: NMICPN im. VP Serbskogo; 2019. 132 p. (In Russ.) 19. Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018;8(9):251–69. DOI: https://doi.org/10.1177/2045125318769235 20. Mosolov SN, Ushkalova AV, Kostyukova EG, et al. Diagnostika bipolyarnogo affektivnogo rasstroistva II tipa sredi patsientov s tekushchim diagnozom rekurrentnogo depressivnogo rasstroistva. Sovremennaya terapiya psikhicheskikh rasstroistv. 2014;(2):2–12. (In Russ.) 21. Mosolov SN, Shafarenko AA, Ushkalova AV, et al. Formalizovannaya diagnostika bipolyarnogo affektivnogo rasstroistva u bol'nykh s pristupoobraznoi shizofreniei i shizoaffektivnym rasstroistvom. Sovremennaya terapiya psikhicheskikh rasstroistv. 2014;(3):2–7. (In Russ.) 22. Vieta E, Sanches-Moreno J, Bulbena A, et al. Cross validation with the mood disorder questionnaire (MDQ) of an instrument for the detection of hypomania in Spanish: the 32 item hypomania symptom check list (HCL-32). J Affect Disord. 2007;101(1–3):43–55. DOI: https://doi.org/10.1016/j.jad.2006.09.040 23. Mosolov SN, Ushkalova AV, Kostiukova EG, et al. Validation of the Russian version of the hypomania checklist (HCL-32) for the detection of bipolar ii disorder in patients with a current diagnosis of recurrent depression. J Affect Disord. 2014;155(1):90–5. DOI: https://doi.org/10.1016/j.jad.2013.10.029 24. Mosolov SN, Ushkalova AV, Kostyukova EG, et al. Validizatsiya rossiiskoi versii oprosnika HCL-32 dlya vyyavleniya patsientov s bipolyarnym affektivnym rasstroistvom II tipa sredi bol'nykh, nablyudayushchikhsya s diagnozom rekurrentnogo depressivnogo epizoda. Sotsial'naya i klinicheskaya psikhiatriya. 2015;(1):21–30. (In Russ.) 25. Gamma A, Angst J, Azorin J-M, et al. Transcultural validity of the Hypomania Checklist-32 (HCL-32) in patients with major depressive episodes. Bipolar Disord. 2013;15(6):701–12. DOI: https://doi.org/10.1111/bdi.12101 26. Feng Y, Xiang YT, Huang W, et al. The 33-item Hypomania Checklist (HCL-33): A new self-completed screening instrument for bipolar disorder. J Affect Disord. 2016;190:214–20. DOI: https://doi.org/10.1016/j.jad.2015.09.057 27. Łojko D, Dudek D, Angst J, et al. The 33-item Hypomania Checklist (HCL-33) – a study of the consistency between self – and external assessments in Polish bipolar patients. Kwestionariusz Hypomania Checklist (HCL-33) u polskich pacjentów z chorobą afektywną dwubiegunową – badanie zgodności między oceną własną a oceną przez osobę z zewnątrz. Psychiatr Pol. 2016;50(6):1085–92. DOI: https://doi.org/10.12740/PP/66358 28. Wang YY, Feng Y, Xu DD, et al. The development and validation of a short version of the 33-item Hypomania Checklist (HCL-33). J Affect Disord. 2018;235:206–10. DOI: https://doi.org/10.1016/j.jad.2018.04.019 29. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33. PMID: 9881538 30. Berk M, Dodd S. Bipolar II disorder: a review. Bipolar Disord. 2005;7(1):11–21. DOI: https://doi.org/10.1111/j.1399-5618.2004.00152.x 31. Scott J, Leboyer M. Consequences of delayed diagnosis of bipolar disorders. Encephale. 2011;37(Suppl 3):S173–5. DOI: https://doi.org/10.1016/S0013-7006(11)70048-3 32. Abhari SAA, Sadeghi M, Ardestani SMS, et al. Undiagnosed Bipolar Disorders in Patients with Major Depressive Episode: Iran’s part of a Multicenter Cross-Sectional Study. Iran J Psychiatry. 2013;8(1):1–6. PMID: 23682245 33. Yang HC, Yuan CM, Liu TB, et al. Validity of the 32-item Hypomania Checklist (HCL-32) in a clinical sample with mood disorders in China. BMC Psychiatry. 2011;11:84. DOI: https://doi.org/10.1186/1471-244X-11-84 34. Wu YS, Angst J, Ou CS, et al. Validation of the Chinese version of the Hypomania Checklist (HCL-32) as an instrument for detecting hypo(mania) in patients with mood disorders. J Affect Disord. 2008;106(1–2):133–43. DOI: https://doi.org/10.1016/j.jad.2007.06.004 35. Kostyukova EG, Mazo GE, Mosolov SN. Bipolyarnoe affektivnoe rasstroistvo. Klinicheskie rekomendatsii. Vzrosly’e. Minzdrav RF. 2021. URL: https://cr.minzdrav.gov.ru/recomend/675_1 (accessed on: 11.09.2021).
DOI: http://dx.doi.org/10.47877/1560-957Х-2021-10607
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