Different patterns of manic/hypomanic symptoms in depression: A pilot modification of the hypomania checklist-32 to assess mixed depression
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Date
2015
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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. © 2014 Elsevier B.V. All rights reserved.
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Keywords
Adult , Bipolar Disorder , Checklist , Cross-Sectional Studies , Cyclothymic Disorder , Depression , Depressive Disorder, Major , Diagnosis, Differential , Diagnostic and Statistical Manual of Mental Disorders , Factor Analysis, Statistical , Female , Humans , Interview, Psychological , Male , Middle Aged , Pilot Projects , Psychomotor Agitation , Risk Factors , adult , Article , bipolar disorder , depression , female , goal attainment , gold standard , high risk behavior , human , hypomania , Hypomania Checklist 32 , impulsiveness , irritability , major clinical study , major depression , male , mania , mixed mania and depression , screening test , Structured Clinical Interview for DSM Disorders , substance use , bipolar disorder , checklist , cross-sectional study , Cyclothymic Disorder , depression , Depressive Disorder, Major , Diagnostic and Statistical Manual of Mental Disorders , differential diagnosis , factor analysis , middle aged , pilot study , psychological interview , Psychomotor Agitation , risk factor , standards