title: The use of Mood Disorder Questionnaire, Hypomania Checklist-32 and clinical predictors for screening previously unrecognised bipolar disorder in a general psychiatric setting.
abstract: Bipolar disorder is often unrecognised and misdiagnosed in the general psychiatric setting. This study compared the psychometric properties of the Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32), examined the clinical predictors of bipolar disorder and determined the best approach for screening previously unrecognised bipolar disorder in a general psychiatric clinic. A random sample of 340 non-psychotic outpatients with no previous diagnosis of bipolar disorder completed the MDQ and HCL-32 during their scheduled clinic visits. Mood and alcohol/substance use disorders were reassessed using a telephone-based Structured Clinical Interview for DSM-IV. We found that the HCL-32 had better psychometric performance and discriminatory capacity than the MDQ. The HCL-32's internal consistency and 4-week test-retest reliability were higher. The area under the curve was also greater than that of the MDQ at various clustering and impairment criteria. The optimal cut-off of the MDQ was co-occurrence of four symptoms with omission of the impairment criterion; for the HCL-32, it was 11 affirmative responses. Multivariable logistic regression found that bipolar family history was associated with an increased risk of bipolar disorder (odds ratio=4.93). The study showed that simultaneous use of the HCL-32 and bipolar family history was the best approach for detecting previously unrecognised bipolar disorder.
authors.affiliation: Department of Psychiatry, Queen Mary Hospital, Hong Kong, China.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Poon
authors.forename: Ka-Fai
authors.initials: KF
authors.lastname: Chung
authors.forename: Kwok-Chu
authors.initials: KC
authors.lastname: Tso
authors.forename: Chi-Lok
authors.initials: CL
authors.lastname: Chang
authors.forename: Dorothy
authors.initials: D
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D057189:Checklist; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult