title: Investigation of the clinical utility of the hypomania checklist 32 (HCL-32) for the screening of bipolar disorders in the non-clinical adult population.
abstract: BACKGROUND
  The hypomania checklist-32 (HCL-32) is a widely used questionnaire developed for identifying hypomanic components in patients with a depressive episode. Measuring and screening previous hypomanic symptoms in individuals without any definite history of depressive episode would also be needed for early detection of bipolar disorders (BDs). This study aimed at testing the clinical utility of the HCL-32 for screening of BDs in the non-clinical population.
  
  
  METHODS
  Lifetime history of hypomanic symptoms was evaluated by using the HCL-32 in 220 patients with BDs and 313 non-clinical individuals. Sensitivity, specificity, and the area under the curve (AUC) of the Receiver Operating Characteristic (ROC) were evaluated for assessing the discriminatory power of the scale and its two sub-domains in screening BDs.
  
  
  RESULTS
  The mean HCL-32 total score was significantly higher in the Bipolar II disorder group compared to the non-clinical group (P < 0.001). Most of the items (10/12) of the irritable/risk-taking factor showed higher positive responses in patient groups. Items of active/elated factor showed mixed results. The HCL-32 total score and the active/elated factor score were not adequate for both BDs and its subgroups with AUC values of less than 0.7. The irritable/risk-taking factor score showed higher discrimination power, i.e. AUC for BDs, Bipolar I disorder, and Bipolar II disorder was 0.71, 0.67, and 0.75, respectively.
  
  
  CONCLUSIONS
  The HCL-32 could not adequately distinguish BD patients from the non-clinical adult population. However, the current study identified items of irritable/risk-taking factor of the scale that could be useful in screening BDs in the general population.
authors.affiliation: Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.|Present address: Department of Psychiatry, St. Andrew's Hospital, Icheon, Republic of Korea.
authors.forename: Kounseok
authors.initials: K
authors.lastname: Lee
authors.affiliation: Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Republic of Korea.
authors.forename: Hyeji
authors.initials: H
authors.lastname: Oh
authors.affiliation: Depression Center, Samsung Medical Center, Seoul, Republic of Korea.
authors.forename: Eun-Ho
authors.initials: EH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
authors.forename: Ji-Hae
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea. hongks@skku.edu.|Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Republic of Korea. hongks@skku.edu.
authors.forename: Kyung Sue
authors.initials: KS
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis*; D057189:Checklist / Q000592:standards*; D003863:Depression / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis*; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Bipolar disorder; Hypomania checklist-32; Screening