title: [Early detection of hypomania episodes in patients with affective disorder].
abstract: BACKGROUND
  Bipolar disorder (BP) is one of the major causes of disability in the world. Epidemiological studies suggest that this disorder could be under-diagnosed owing to the difficulty in detecting hypomania episodes. The detection of present and past episodes of hypomania could help in the diagnosis and appropriate treatment of this disorder. The Hypomania Check List (HCL-32) is a questionnaire validated into Spanish and designed to detect past and present hypomania episodes in the psychiatric patient population.
  
  
  METHODS
  A total of 128 patients over 18 years old and diagnosed with type I bipolar (BP-I) disorder (n=1), type II bipolar (BP-II) disorder (n=30), major depression (MD) (n=57), anxiety disorders (AD) (n=15) were selected, along with a control group (C) (n=25). The patients were diagnosed according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IVTR). Screening for hypomania episodes was carried out by applying the HCL-32 scale.
  
  
  RESULTS
  The area under the ROC curve was 0.65 with a 95% confidence interval (CI) of 0.55-0.75. The chosen cut-off point of the HCL-32 was 15. The values for the sensitivity (Se), specificity (Sp), positive predictive values (PPV) and negative predictive values (NPV), and the prevalence (P) of hypomania episodes in the patients of the UP depression, for a cut-off point of 15 were: Se =71.4%, 95% CI; 57.8, 85.1, Sp =45.8%, 95% CI; 34.5-57.1, PPV=43.75%, 95% CI; 32.25-55.25), NPV:73.08%, 95% CI; 60.06-86.09) and P=67.2%.
  
  
  CONCLUSIONS
  The HCL-32 is a very sensitive, but not very specific, screening tool. This could partly explain the high proportion of hypomania episodes detected in our sample. Unlike previous studies, our sample is heterogeneous (from different environments) and at a more severe and unstable clinical level. Future research should develop more specific measuring tools, and with greater external validation, for hypomania episodes.
authors.affiliation: Unidad de Psiquiatría, Hospital Puerta de Hierro, Majadahonda, Madrid, España. inesgarciac@hotmail.com
authors.forename: Inés
authors.initials: I
authors.lastname: García-Castillo
authors.forename: Lidia
authors.initials: L
authors.lastname: Fernández-Mayo
authors.forename: Elena
authors.initials: E
authors.lastname: Serrano-Drozdowskyij
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Carmona
authors.forename: María José
authors.initials: MJ
authors.lastname: Martín-Calvo
authors.forename: Santiago
authors.initials: S
authors.lastname: Ovejero
authors.forename: Isabel
authors.initials: I
authors.lastname: Millán
authors.forename: Fernando
authors.initials: F
authors.lastname: García
authors.forename: Enrique
authors.initials: E
authors.lastname: Baca-García
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000209:etiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications