Different patterns of manic/hypomanic symptoms in depression: A pilot modification of the hypomania checklist-32 to assess mixed depression

Miguel L. Prieto, Eric A. Youngstrom, Aysegul Ozerdem, Kursat Altinbas, Danilo Quiroz, Omer Aydemir, Nefize Yalin, Jennifer R. Geske, Scott E. Feeder, Jules Angst, Mark A. Frye*

*Autor correspondiente de este trabajo

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

19 Citas (Scopus)


Methods The study sample consisted of 188 patients with Structured Clinical Interview for DSM-IV-TR disorders (SCID) confirmed bipolar or major depressive disorder. We modified the Hypomania Checklist-32 (mHCL-32) to assess current instead of lifetime symptoms. An Exploratory Factor Analysis (EFA) was conducted to identify clusters of mHCL-32 items that were endorsed concurrently. A Latent Class Analysis (LCA) was carried out to identify groups of patients with similar mHCL-32 item endorsement patterns.
Background There are no self-report scales that assess manic/hypomanic symptoms in patients with depression. The aim of this study was to explore the use of a modified screening instrument for bipolar disorder to assess current manic/hypomanic symptoms in patients with a depressive episode.
Results The EFA identified 3 factors: factor #1 ("elation-disinhibition-increased goal directed activity"), factor #2 ("risk-taking-impulsivity-substance use") and factor #3 (distractibility-irritability). The LCA yielded 3 classes (2 showing manic/hypomanic features). While class #1 patients endorsed more items related to disinhibition and racing thoughts, class #2 patients recognized more items associated with irritability and substance use.
Limitations Lack of an adequate gold standard measure of mixed depression to compare to, the cross-sectional design and the lack of a validation sample.
Conclusions The mHCL-32 scale allowed a comprehensive and convergent delineation of hypomanic/manic symptoms in depression. Further validation of these findings is needed.
Idioma originalInglés
Páginas (desde-hasta)355-360
Número de páginas6
PublicaciónJournal of Affective Disorders
EstadoPublicada - 1 feb. 2015

Nota bibliográfica

Publisher Copyright:
© 2014 Elsevier B.V. All rights reserved.

Palabras clave

  • Bipolar disorder
  • Manic/hypomanic
  • mHCL-32 scale
  • Mixed depression


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