The HCL-32: Towards a self-assessment tool for hypomanic symptoms in outpatients

The HCL-32: Towards a self-assessment tool for hypomanic symptoms in outpatients
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DOI:
10.1016/j.jad.2005.05.011
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发表时间:
2005-10-01
影响因子:
6.6
通讯作者:
Scott, J
Scott, J
中科院分区:
医学2区
文献类型:
--
作者:
Angst, J;Adolfsson, R;Scott, J

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背景:双相情感障碍(BP)最初经常被诊断为纯粹的抑郁症并进行治疗;准确的诊断往往会延迟8至10年。在前瞻性研究中,青春期出现的轻躁狂症状强烈预示着后来的双相情感障碍。因此,用于轻躁狂症状自我评估的工具可能会增加对疑似和明显但未得到充分治疗的双相情感障碍病例的检测。方法:多语言轻躁狂检查表(HCL-32)已经制定并正在国际上进行测试。这篇初步论文报告了该量表在区分 BP 患者 (N=266) 和重度抑郁症患者 (MDD; N= 160) 方面的表现。这些样本是在意大利 (N = 186) 和瑞典 (N = 240) 招募的成年精神病患者。 结果:样本报告了相似的临床特征,HCL-32 的结构证明了两个主要因素,即“活跃/兴高采烈”的轻躁狂和“冒险/易怒”的轻躁狂。 HCL-32 区分 BP 和 MDD 的敏感性为 80%,特异性为 51%。 局限性:虽然 HCL-32 是轻躁狂症状的敏感工具,但它不能区分 BP-1 和 BP-11 疾病。结论:未来的研究应该测试是否有不同的项目组合。可能记录轻躁狂的后果,可以区分这些 BP 亚型。 (c) 2005 Elsevier B.V. 保留所有权利。
Background: Bipolar disorders (BP) are frequently diagnosed and treated as pure depression initially; accurate diagnosis often being delayed by 8 to 10 years. In prospective studies, the presence of hypomanic symptoms in adolescence is strongly predictive of later bipolar disorders. As such, an instrument for self-assessment of hypomanic symptoms might increase the detection of suspected and of manifest, but under-treated, cases of bipolar disorders.Methods: The multi-lingual hypomania checklist (HCL-32) has been developed and is being tested internationally. This preliminary paper reports the performance of the scale in distinguishing individuals with BP (N=266) from those with major depressive disorder (MDD; N= 160). The samples were adult psychiatry patients recruited in Italy (N= 186) and Sweden (N=240).Results: The samples reported similar clinical profiles and the structure for the HCL-32 demonstrated two main factors identified as "active/elated" hypomania and "risk-taking/irritable" hypomania. The HCL-32 distinguished between BP and MDD with a sensitivity of 80% and a specificity of 51%.Limitations: Although the HCL-32 is a sensitive instrument for hypomanic symptoms, it does not distinguish between BP-1 and BP-11 disorders.Conclusions: Future studies should test if different combinations of items. possibly recording the consequences of hypomania, can distinguish between these BP subtypes. (c) 2005 Elsevier B.V. All rights reserved.