title: e-HCL-32: a useful, valid and user friendly tool in the screening of bipolar II disorder.
abstract: OBJECTIVE
  Bipolar type II (BDII) is a frequent disorder with high morbidity and mortality, characterized by depressive and hypomanic episodes. Early diagnosis can be effective in improving long-term prognosis. However, diagnosing BDII is challenging due to the difficulty in detecting past hypomanic episodes. The HCL-32 is a widely used and reliable screening instrument for the detection of past hypomanic episodes. Making this tool available to more patients could help diagnose and treat undetected cases of BDII earlier. New technologies such as the Internet have been previously used for this purpose with favorable outcomes. Accordingly, the objective of this study is to evaluate the acceptability, validity, reliability and equivalence of an online version of this questionnaire.
  
  
  METHODS
  From May 2012 to March 2013, 52 participants attending an outpatient mental health clinic completed a paper version of the HCL-32 (HCL-32) and its online version (e-HCL-32) within two weeks. After its completion, they were asked to answer a brief satisfaction survey.
  
  
  RESULTS
  No differences were found (HCL-32 mean total score=17.73 (SD=7.37), e-HCL-32 mean total score=18.28 (SD=7.09). T=-1.720, p=0.092, 95% CI=-1.21 to 0.09) between the results of the paper and pencil HCL-32 compared to its online version (e-HCL-32). The psychometric properties of the online version of the hypomania checklist (e-HCL-32) were good and comparable to the paper and pencil version. 80% of participants found online questionnaires to be easier to answer and more user-friendly.
  
  
  CONCLUSIONS
  The results of this study support the use of an online screening tool for the detection of previous hypomanic episodes (necessary for BDII diagnosis) as it showed to have a similar validity and reliability to the traditional paper and pencil method.
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Hidalgo-Mazzei
authors.affiliation: Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain.
authors.forename: Ainoa
authors.initials: A
authors.lastname: Mateu
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain; Departament of Psychiatry, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
authors.forename: Juan
authors.initials: J
authors.lastname: Undurraga
authors.affiliation: Laboratory of Molecular Psychiatry, INCT for Translational Medicine - CNPq, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Graduate Program in Medicine: Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Adriane R
authors.initials: AR
authors.lastname: Rosa
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain.
authors.forename: Isabella
authors.initials: I
authors.lastname: Pacchiarotti
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain.
authors.forename: Caterina del Mar
authors.initials: Cdel M
authors.lastname: Bonnin
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Sánchez-Moreno
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Colom
authors.affiliation: Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain. Electronic address: evieta@clinic.ub.es.
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D014584:User-Computer Interface; D055815:Young Adult