MedWire News: Researchers have found that a shortened 16-item version of the Hypomania Checklist (HCL-16) reliably differentiates between patients with bipolar disorder (BD) and major depressive disorder (MDD), without loss in sensitivity or specificity compared with the full version of the questionnaire (HCL-32).
Daniel Smith (Cardiff University, Wales, UK) and colleagues explain that although the HCL-32 is a “promising screening questionnaire for the correct identification of both BD I and BD II in a range of clinical and non-clinical settings, its length and format may make it difficult to use in busy clinical practice (such as primary care).”
The team initially performed item correlations to identify potentially redundant items in the HCL-32 in 230 patients with Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-confirmed BD I and 322 patients with confirmed recurrent MDD. The patients had a mean illness duration of 21.5 years.
The performance of a shortened 16-item HCL questionnaire within a separate sample of patients with BD (n=59) and MDD (n=76) was then tested.
A score of eight or more on the HCL-16 – compared with a score of 18 or more for the HCL-32 – reliably distinguished between BD and MDD, with a sensitivity of 83% and specificity of 71%, which was similar to that for the full 32-item HCL. The positive and negative predictive values of the HCL-16 were found to be 69% and 84%, respectively.
Two main factors similar to those seen in the HCL-32 were observed in the HCL-16, namely an “active-elated” factor and “risk-taking/irritable” factor.
The researchers caution that since the HCL-16 was derived after participants had completed the full HCL-32, “it will be important to test the validity of a ‘stand-alone’ 16-item HCL questionnaire.”
Writing in the Journal of Affective Disorders, the authors conclude: “Although the current findings require replication, we believe that the HCL-16 may provide an effective screening tool for use in primary care settings.”
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