title: Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ).
abstract: OBJECTIVE
  Bipolar disorders are often not recognized and undertreated. The diagnosis of current or past episodes of hypomania is of importance in order to increase diagnostic certainty. The Hypomania Checklist-32 is a self-applied questionnaire aimed at recognizing these episodes. As part of the international collaborative effort to develop multi-lingual versions of the Hypomania Checklist-32, we aimed to validate the Brazilian version and to compare its psychometric properties with those of the Mood Disorder Questionnaire.
  
  
  METHODS
  Adult outpatients with bipolar disorder I (n=37), bipolar disorder II (n=44) and major depressive disorder (n=42) of a specialized mood disorder unit were diagnosed according to DSM-IV-TR using a modified version of the SCID. We analyzed the internal consistency and discriminative ability of the Hypomania Checklist-32 Brazilian version in relation to the Mood Disorder Questionnaire.
  
  
  RESULTS
  The internal consistency of the Brazilian Hypomania Checklist-32, analyzed using Cronbach's alpha coefficient, was 0.86. A score of 18 or higher in the Hypomania Checklist-32 Brazilian version distinguished between bipolar disorder and major depressive disorder, with a sensitivity of 0.75 and a specificity of 0.58, compared to 0.70 and 0.58, respectively, for the Mood Disorder Questionnaire (score>7). The Hypomania Checklist-32 Brazilian version showed a dual factor structure characterized by "active/elated" and "risk-taking/irritable" items. Hence, the Hypomania Checklist-32 Brazilian version was found to have a higher sensitivity but the same specificity as the Mood Disorder Questionnaire.
  
  
  CONCLUSIONS
  The Brazilian version of the Hypomania Checklist-32 has adequate psychometric properties and helps discriminating bipolar disorder from major depressive disorder (but not bipolar disorder I from bipolar disorder II) with good sensitivity and specificity indices, similar to those of the Mood Disorder Questionnaire.
authors.affiliation: Mood Disorders Unit, Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Odeilton Tadeu
authors.initials: OT
authors.lastname: Soares
authors.forename: Doris Hupfeld
authors.initials: DH
authors.lastname: Moreno
authors.forename: Eduardo Calmon de
authors.initials: EC
authors.lastname: Moura
authors.forename: Jules
authors.initials: J
authors.lastname: Angst
authors.forename: Ricardo Alberto
authors.initials: RA
authors.lastname: Moreno
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D057189:Checklist / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis* / Q000523:psychology; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D014177:Translations; D055815:Young Adult