Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic
Introduction: Hypomania symptoms are best described as a continuum, ranging beyond Bipolar Spectrum Disorders (BSD). Other nosological entities, such as major depressive disorder, schizoaffective disorder, or borderline personality disorder, may also share symptoms with BSD, raising challenges for d...
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Frontiers Media S.A.
2018-11-01
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Series: | Frontiers in Psychiatry |
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Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2018.00527/full |
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author | Marta Camacho Sílvia Almeida Sílvia Almeida Ana Rita Moura Ana Rita Moura Ana B. Fernandes Ana B. Fernandes Ana B. Fernandes Gabriela Ribeiro Gabriela Ribeiro Gabriela Ribeiro Joaquim Alves da Silva Joaquim Alves da Silva Joaquim Alves da Silva J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa Albino J. Oliveira-Maia Albino J. Oliveira-Maia Albino J. Oliveira-Maia Albino J. Oliveira-Maia |
author_facet | Marta Camacho Sílvia Almeida Sílvia Almeida Ana Rita Moura Ana Rita Moura Ana B. Fernandes Ana B. Fernandes Ana B. Fernandes Gabriela Ribeiro Gabriela Ribeiro Gabriela Ribeiro Joaquim Alves da Silva Joaquim Alves da Silva Joaquim Alves da Silva J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa Albino J. Oliveira-Maia Albino J. Oliveira-Maia Albino J. Oliveira-Maia Albino J. Oliveira-Maia |
author_sort | Marta Camacho |
collection | DOAJ |
description | Introduction: Hypomania symptoms are best described as a continuum, ranging beyond Bipolar Spectrum Disorders (BSD). Other nosological entities, such as major depressive disorder, schizoaffective disorder, or borderline personality disorder, may also share symptoms with BSD, raising challenges for differential diagnosis. While the Hypomania Checklist-32 is one of the most widely used tools for screening hypomania, there is limited evidence describing its use in a real-world outpatient psychiatric clinical setting.Methods: Here we tested the psychometric properties of a European Portuguese adaptation of the HCL-32, establishing its factor structure, reliability and construct validity. Furthermore, we analyzed differences in hypomanic symptoms among several clinical groups and in a non-clinical sample. Data was obtained retrospectively in an ecological setting from a clinical sample of an outpatient psychiatry and psychology clinic, comprising 463 Portuguese individuals, 326 of whom had a psychiatric diagnosis, namely BSD (n = 66), major depressive disorder (n = 116), or other psychiatric disorders (n = 144). A separate non-clinical sample was also collected among healthy volunteers (n = 62). A battery of self-report measures of affective symptoms was applied, and in a subset of patients, diagnosis was established using a structured diagnostic interview.Results: Psychometric properties of the HCL-32 were adequate, with good internal consistency (Cronbach's α = 0.86) and test-retest stability (ICC = 0.86), and two subscores (“active/elated” and “risk-taking/irritable”) defined by Principal Component Analysis. Receiver Operating Characteristic curve analysis demonstrated that the test score discriminated moderately between patients with BSD and other clinical samples as well as healthy volunteers, with a cut-off score of 17 for the total score of the HCL-32 rendering the best combination of sensitivity and specificity. When compared to the HCL-32 total score, the risk-taking/irritable subscore seems to provide additional benefit in discriminating between different clinical groups, namely regarding specificity in the discrimination from patients with a diagnosis of major depressive disorder that was low for the full scale and the alternate subscale.Conclusions: HCL-32 can be used as a screening tool for BSD among adult patients presenting in an outpatient psychiatric clinical setting. |
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language | English |
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publishDate | 2018-11-01 |
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series | Frontiers in Psychiatry |
spelling | doaj.art-e0a4d2af9a354d608ec6674f6355e2392022-12-22T03:31:01ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402018-11-01910.3389/fpsyt.2018.00527414682Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry ClinicMarta Camacho0Sílvia Almeida1Sílvia Almeida2Ana Rita Moura3Ana Rita Moura4Ana B. Fernandes5Ana B. Fernandes6Ana B. Fernandes7Gabriela Ribeiro8Gabriela Ribeiro9Gabriela Ribeiro10Joaquim Alves da Silva11Joaquim Alves da Silva12Joaquim Alves da Silva13J. Bernardo Barahona-Corrêa14J. Bernardo Barahona-Corrêa15J. Bernardo Barahona-Corrêa16J. Bernardo Barahona-Corrêa17Albino J. Oliveira-Maia18Albino J. Oliveira-Maia19Albino J. Oliveira-Maia20Albino J. Oliveira-Maia21Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Research, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalDepartment of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, PortugalChampalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Research, Champalimaud Centre for the Unknown, Lisbon, PortugalNOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, PortugalChampalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Research, Champalimaud Centre for the Unknown, Lisbon, PortugalLisbon Academic Medical Center PhD Program, Faculdade de Medicina, Universidade de Lisboa, Lisbon, PortugalChampalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Research, Champalimaud Centre for the Unknown, Lisbon, PortugalNOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, PortugalChampalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Research, Champalimaud Centre for the Unknown, Lisbon, PortugalDepartment of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, PortugalNOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, PortugalChampalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, PortugalChampalimaud Research, Champalimaud Centre for the Unknown, Lisbon, PortugalDepartment of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, PortugalNOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, PortugalIntroduction: Hypomania symptoms are best described as a continuum, ranging beyond Bipolar Spectrum Disorders (BSD). Other nosological entities, such as major depressive disorder, schizoaffective disorder, or borderline personality disorder, may also share symptoms with BSD, raising challenges for differential diagnosis. While the Hypomania Checklist-32 is one of the most widely used tools for screening hypomania, there is limited evidence describing its use in a real-world outpatient psychiatric clinical setting.Methods: Here we tested the psychometric properties of a European Portuguese adaptation of the HCL-32, establishing its factor structure, reliability and construct validity. Furthermore, we analyzed differences in hypomanic symptoms among several clinical groups and in a non-clinical sample. Data was obtained retrospectively in an ecological setting from a clinical sample of an outpatient psychiatry and psychology clinic, comprising 463 Portuguese individuals, 326 of whom had a psychiatric diagnosis, namely BSD (n = 66), major depressive disorder (n = 116), or other psychiatric disorders (n = 144). A separate non-clinical sample was also collected among healthy volunteers (n = 62). A battery of self-report measures of affective symptoms was applied, and in a subset of patients, diagnosis was established using a structured diagnostic interview.Results: Psychometric properties of the HCL-32 were adequate, with good internal consistency (Cronbach's α = 0.86) and test-retest stability (ICC = 0.86), and two subscores (“active/elated” and “risk-taking/irritable”) defined by Principal Component Analysis. Receiver Operating Characteristic curve analysis demonstrated that the test score discriminated moderately between patients with BSD and other clinical samples as well as healthy volunteers, with a cut-off score of 17 for the total score of the HCL-32 rendering the best combination of sensitivity and specificity. When compared to the HCL-32 total score, the risk-taking/irritable subscore seems to provide additional benefit in discriminating between different clinical groups, namely regarding specificity in the discrimination from patients with a diagnosis of major depressive disorder that was low for the full scale and the alternate subscale.Conclusions: HCL-32 can be used as a screening tool for BSD among adult patients presenting in an outpatient psychiatric clinical setting.https://www.frontiersin.org/article/10.3389/fpsyt.2018.00527/fullhypomaniabipolar spectrum disordersHCL-32adaptationEuropean Portuguese |
spellingShingle | Marta Camacho Sílvia Almeida Sílvia Almeida Ana Rita Moura Ana Rita Moura Ana B. Fernandes Ana B. Fernandes Ana B. Fernandes Gabriela Ribeiro Gabriela Ribeiro Gabriela Ribeiro Joaquim Alves da Silva Joaquim Alves da Silva Joaquim Alves da Silva J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa J. Bernardo Barahona-Corrêa Albino J. Oliveira-Maia Albino J. Oliveira-Maia Albino J. Oliveira-Maia Albino J. Oliveira-Maia Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic Frontiers in Psychiatry hypomania bipolar spectrum disorders HCL-32 adaptation European Portuguese |
title | Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic |
title_full | Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic |
title_fullStr | Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic |
title_full_unstemmed | Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic |
title_short | Hypomania Symptoms Across Psychiatric Disorders: Screening Use of the Hypomania Check-List 32 at Admission to an Outpatient Psychiatry Clinic |
title_sort | hypomania symptoms across psychiatric disorders screening use of the hypomania check list 32 at admission to an outpatient psychiatry clinic |
topic | hypomania bipolar spectrum disorders HCL-32 adaptation European Portuguese |
url | https://www.frontiersin.org/article/10.3389/fpsyt.2018.00527/full |
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