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The Hypomania Checklist (HCL-32): its factorial structure and association to indices of impairment in German and Swedish nonclinical samples

Lookup NU author(s): Dr Thomas Meyer



Background Bipolar disorders are often not recognized. Several instruments were developed but none primarily focused on hypomania. The Hypomania Checklist (HCL) is aimed at the identification of bipolarity in outpatients. Using a German and Swedish sample, we investigated if the factor structure in nonclinical samples is similar to the one reported for outpatient samples. Furthermore, we tested if people who probably had a lifetime history of hypomania report more depression or other signs of impairment and if current depression is associated with lifetime hypomania. Method In the German study, participants completed the HCL-32 as an online questionnaire that also included questions about lifetime and current depression (n = 695), whereas the Swedish data relied on the paper-and-pencil version of the HCL-32 completed by a random sample from a representative population sample (n = 408). Results The factor structure of the HCL-32 was fairly similar in both samples and to the ones presented by Angst et al (J Affect Disord 2005;88:217-33). People reporting “highs” (≥4 days and experiencing negative consequences) not only endorsed more HCL-32 symptoms but also had higher rates of current and former depression and psychotherapy. Level of current depression was also associated with lifetime hypomanic symptoms. Discussion and limitation An “active-elated” and “risk-taking/irritable” factor of hypomania can be distinguished with the HCL-32 in clinical and nonclinical samples. Based on our results, the HCL-32 might even be useful as screening tool in nonclinical samples and not only in depressed outpatients. However, our data do not allow estimating sensitivity and specificity of the HCL-32 because structured clinical interviews were not included.

Publication metadata

Author(s): Meyer TD, Hammelstein P, Nilsson L-G, Skeppar P, Adolfsson R, Angst J

Publication type: Article

Publication status: Published

Journal: Comprehensive Psychiatry

Year: 2007

Volume: 48

Issue: 1

Pages: 79-87

Date deposited: 09/10/2008

ISSN (print): 0010-440X

ISSN (electronic): 1532-8384

Publisher: Elsevier


DOI: 10.1016/j.comppsych.2006.07.001


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