| 1. |
- Angst, Jules, et al.
(författare)
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Hypomania : a transcultural perspective
- 2010
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Ingår i: World Psychiatry. - : Elsevier. - 1723-8617 .- 2051-5545. ; 9:1, s. 41-49
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the transcultural robustness of a screening instrument for hypomania, the Hypomania Checklist-32, first revised version (HCL-32 R1). It was carried out in 2606 patients from twelve countries in five geographic regions (Northern, Southern and Eastern Europe, South America and East Asia). In addition, GAMIAN Europe contributed data from its members. Exploratory and confirmatory factor analyses were used to examine the transregional stability of the measurement properties of the HCL-32 R1, including the influence of sex and age as covariates. Across cultures, a two-factor structure was confirmed: the first factor (F1) reflected the more positive aspects of hypomania (being more active, elated, self-confident, and cogni-tively enhanced); the second factor (F2) reflected the more negative aspects (being irritable, impulsive, careless, more substance use). The measurement properties of the HCL-32 R1 were largely invariant across cultures. Only few items showed transcultural differences in their relation to hypomania as measured by the test. F2 was higher among men and in more severe manic syndromes; F1 was highest in North and East Europe and lowest in South America. The scores decreased slightly with age. The frequency of the 32 items showed remarkable similarities across geographic areas, with two excep-tions: South Europeans had lower symptom frequencies in general and East Europeans higher rates of substance use. These findings support the interna-tional applicability of the HCL-32 R1 as a screening instrument for hypomania.
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| 2. |
- Skeppar, Peter, et al.
(författare)
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Neurodevelopmental disorders with comorbid affective disorders sometimes produce psychiatric conditions traditionally diagnosed as schizophrenia
- 2013
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Ingår i: Clinical Neuropsychiatry. - 1724-4935. ; 10:3-4, s. 123-133
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Tidskriftsartikel (refereegranskat)abstract
- The knowledge in psychiatric genetics, neuroanatomy, functional neuroanatomy, neuropsychology, neuropsychopharmacology and clinical psychiatry, has immensely increased in the last decades. Here, the psychiatric conditions schizophrenia, affective disorders and autism spectrum disorder are discussed. Reported findings in relevant literature and our clinical experience in adult psychiatry in line with these findings, are subjects of this article. Disorders that in the last 100 years typically have been described as schizophrenia might today be better viewed as neurodevelopmental disorders (NDD:s), particularly autism spectrum disorder, combined with affective disorders. Also in affective disorders, without any signs and symptoms typical of a diagnosis of schizophrenia, NDD:s are very common, albeit generally less severe. The ensuing view on schizophrenia and on affective disorders respectively has very important and far reaching conceptual and clinical implications.
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| 3. |
- Angst, Jules, et al.
(författare)
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The HCL-32 : towards a self-assessment tool for hypomanic symptoms in outpatients
- 2005
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Ingår i: Journal of Affective Disorders. - Amsterdam : Elsevier. - 0165-0327 .- 1573-2517. ; 88:2, s. 217-233
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bipolar disorders (BP) are frequently diagnosed and treated as pure depression initially; accurate diagnosis often being delayed by 8 to 10 years. In prospective studies, the presence of hypomanic symptoms in adolescence is strongly predictive of later bipolar disorders. As such, an instrument for self-assessment of hypomanic symptoms might increase the detection of suspected and of manifest, but under-treated, cases of bipolar disorders.Methods: The multi-lingual hypomania checklist (HCL-32) has been developed and is being tested internationally. This preliminary paper reports the performance of the scale in distinguishing individuals with BP (N=266) from those with major depressive disorder (MDD; N= 160). The samples were adult psychiatry patients recruited in Italy (N= 186) and Sweden (N=240).Results: The samples reported similar clinical profiles and the structure for the HCL-32 demonstrated two main factors identified as "active/elated" hypomania and "risk-taking/irritable" hypomania. The HCL-32 distinguished between BP and MDD with a sensitivity of 80% and a specificity of 51%.Limitations: Although the HCL-32 is a sensitive instrument for hypomanic symptoms, it does not distinguish between BP-1 and BP-11 disorders.Conclusions: Future studies should test if different combinations of items. possibly recording the consequences of hypomania, can distinguish between these BP subtypes.
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| 4. |
- Meyer, Thomas D, et al.
(författare)
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The Hypomania Checklist (HCL-32) : its factorial structure and association to indices of impairment in German and Swedish nonclinical samples
- 2007
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Ingår i: Comprehensive Psychiatry. - Philadelphia : Saunders Elsevier. - 0010-440X .- 1532-8384. ; 48:1, s. 79-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bipolar disorders are often not recognized. Several instruments were developed but none primarily focused on hypomania. The Hypomania Checklist (HCL) is aimed at the identification of bipolarity in outpatients. Using a German and Swedish sample, we investigated if the factor structure in nonclinical samples is similar to the one reported for outpatient samples. Furthermore, we tested if people who probably had a lifetime history of hypomania report more depression or other signs of impairment and if current depression is associated with lifetime hypomania.Method: In the German study, participants completed the HCL-32 as an online questionnaire that also included questions about lifetime and current depression (n = 695), whereas the Swedish data relied on the paper-and-pencil version of the HCL-32 completed by a ranclorn sample from a representative population sample (n = 408).Results: The factor structure of the HCL-32 was fairly similar in both samples and to the ones presented by Angst et al (J Affect Disord 2005;88:217-33). People reporting "highs" (>= 4 days and experiencing negative consequences) not only endorsed more HCL-32 symptoms but also had higher rates of current and former depression and psychotherapy. Level of current depression was also associated with lifetime hypomanic symptoms.Discussion and limitation: An "active-elated' and "risk-taking/irritable" factor of hypomania can be distinguished with the HCL-32 in clinical and nonclinical samples. Based on our results, the HCL-32 might even be useful as screening toot in nonclinical samples and not only in depressed outpatients. However, our data do not allow estimating sensitivity and specificity of the HCL-32 because structured clinical interviews were not included.
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