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


Prieto M. L., Youngstrom E. A., Ozerdem A., Altinbas K., Quiroz D., AYDEMİR Ö., ...More

Journal of Affective Disorders, vol.172, pp.355-360, 2015 (SCI-Expanded, SSCI, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 172
  • Publication Date: 2015
  • Doi Number: 10.1016/j.jad.2014.09.047
  • Journal Name: Journal of Affective Disorders
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus
  • Page Numbers: pp.355-360
  • Keywords: Bipolar disorder, mHCL-32 scale, Mixed depression, Manic/hypomanic
  • Manisa Celal Bayar University Affiliated: Yes

Abstract

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.