title: Validity of the 32-item Hypomania Checklist (HCL-32) in a clinical sample with mood disorders in China.
abstract: BACKGROUND
  The 32-item Hypomania Checklist (HCL-32), a questionnaire for screening bipolar disorders, has been utilised in several countries, but it unclear if the Chinese version of the HCL-32 is valid.
  
  
  METHODS
  Consecutive patients with bipolar disorders (BP, N = 300) and unipolar major depression (UP, N = 156) completed the Chinese version of the HCL-32. The subjects underwent a structured clinical interview for DSM-IV Axis-I disorders (SCID).
  
  
  RESULTS
  The eigenvalues for the first three factors in the HCL-32 were calculated as 5.16 (active/elated), 2.72 (risk-taking) and 2.48 (irritable) using factor analysis. Cronbach's alpha for the HCL-32 was calculated to be 0.88. Positive responses to twenty-eight items were significantly more frequent by patients with BP than those with UP, and the other four items (7th, 21st, 25th and 32nd) showed no such trend. Fourteen was the optimal cut-off for discriminating between BP and UP. The HCL-32 distinguished between BP-II and UP, with 13 being the optimal cut-off. A cut-off of 13 yielded a sensitivity of 0.77 and a specificity of 0.62 between BP and UP.
  
  
  CONCLUSIONS
  This study demonstrated that the simplified Chinese version of HCL-32 was valid for patients with mood disorders. The optimal cut-off of 13 for distinguishing between BP-II and UP was valid and could be used to improve the sensitivity of screening BP-II patients when the HCL-32 is used in psychiatric settings in China.
authors.affiliation: Mental Health Institute, the 2nd Xiangya Hospital, Central South University, Changsha 410011, China.
authors.forename: Hai-chen
authors.initials: HC
authors.lastname: Yang
authors.forename: Cheng-mei
authors.initials: CM
authors.lastname: Yuan
authors.forename: Tie-bang
authors.initials: TB
authors.lastname: Liu
authors.forename: Ling-jiang
authors.initials: LJ
authors.lastname: Li
authors.forename: Hong-jun
authors.initials: HJ
authors.lastname: Peng
authors.forename: Chun-ping
authors.initials: CP
authors.lastname: Liao
authors.forename: Han
authors.initials: H
authors.lastname: Rong
authors.forename: Yi-ru
authors.initials: YR
authors.lastname: Fang
authors.forename: Jules
authors.initials: J
authors.lastname: Angst
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis*; D057189:Checklist / Q000379:methods / Q000706:statistics & numerical data*; D002681:China; D003865:Major Depressive Disorder / Q000175:diagnosis*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D012372:ROC Curve