title: Different patterns of manic/hypomanic symptoms in depression: A pilot modification of the hypomania checklist-32 to assess mixed depression.
abstract: BACKGROUND
  There are no self-report scales that assess manic/hypomanic symptoms in patients with depression. The aim of this study was to explore the use of a modified screening instrument for bipolar disorder to assess current manic/hypomanic symptoms in patients with a depressive episode.
  
  
  METHODS
  The study sample consisted of 188 patients with Structured Clinical Interview for DSM-IV-TR disorders (SCID) confirmed bipolar or major depressive disorder. We modified the Hypomania Checklist-32 (mHCL-32) to assess current instead of lifetime symptoms. An Exploratory Factor Analysis (EFA) was conducted to identify clusters of mHCL-32 items that were endorsed concurrently. A Latent Class Analysis (LCA) was carried out to identify groups of patients with similar mHCL-32 item endorsement patterns.
  
  
  RESULTS
  The EFA identified 3 factors: factor #1 ("elation-disinhibition-increased goal directed activity"), factor #2 ("risk-taking-impulsivity-substance use") and factor #3 (distractibility-irritability). The LCA yielded 3 classes (2 showing manic/hypomanic features). While class #1 patients endorsed more items related to disinhibition and racing thoughts, class #2 patients recognized more items associated with irritability and substance use.
  
  
  CONCLUSIONS
  Lack of an adequate gold standard measure of mixed depression to compare to, the cross-sectional design and the lack of a validation sample.
  
  
  CONCLUSIONS
  The mHCL-32 scale allowed a comprehensive and convergent delineation of hypomanic/manic symptoms in depression. Further validation of these findings is needed.
authors.affiliation: Universidad de los Andes, Facultad de Medicina, Departamento de Psiquiatría, Santiago, Chile; Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Miguel L
authors.initials: ML
authors.lastname: Prieto
authors.affiliation: Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Youngstrom
authors.affiliation: Department of Psychiatry, Dokuz Eylul University, Izmir, Turkey; Department of Neuroscience, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Ozerdem
authors.affiliation: Department of Psychiatry, Canakkale Onsekiz Mart University, Canakkale, Turkey.
authors.forename: Kursat
authors.initials: K
authors.lastname: Altinbas
authors.affiliation: Efeso Mood Clinic, Santiago, Chile.
authors.forename: Danilo
authors.initials: D
authors.lastname: Quiroz
authors.affiliation: Department of Psychiatry, Celal Bayar University, Manisa, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Aydemir
authors.affiliation: Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Nefize
authors.initials: N
authors.lastname: Yalin
authors.affiliation: Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Geske
authors.affiliation: Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Feeder
authors.affiliation: Zürich University Psychiatric Hospital, Zurich, Switzerland.
authors.forename: Jules
authors.initials: J
authors.lastname: Angst
authors.affiliation: Mayo Clinic Depression Center, Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA. Electronic address: mfrye@mayo.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Frye
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis*; D057189:Checklist / Q000592:standards; D003430:Cross-Sectional Studies; D003527:Cyclothymic Disorder / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D003865:Major Depressive Disorder / Q000175:diagnosis*; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000592:standards*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011595:Psychomotor Agitation / Q000175:diagnosis; D012307:Risk Factors
keywords: Bipolar disorder; Manic/hypomanic; Mixed depression; mHCL-32 scale