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

Research output: Contribution to journalArticle

10 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)355-360
Number of pages6
JournalJournal of Affective Disorders
Volume172
DOIs
StatePublished - Feb 1 2015

Keywords

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

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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    Prieto, M. L., Youngstrom, E. A., Ozerdem, A., Altinbas, K., Quiroz, D., Aydemir, O., Yalin, N., Geske, J. R., Feeder, S. E., Angst, J., & Frye, M. A. (2015). Different patterns of manic/hypomanic symptoms in depression: A pilot modification of the hypomania checklist-32 to assess mixed depression. Journal of Affective Disorders, 172, 355-360. https://doi.org/10.1016/j.jad.2014.09.047