The Hypomania Check List-32 in distinguishing potential patients with bipolar disorder among depression patients

Objective To assess results of the Hypomania Check List-32 (HCL-32) in Chinese depression patients for discriminating possible bipolar depression. Methods Totally 128 patients with depression meeting diagnostic criteria of depression in CCMD-3 and DSM-Ⅳ was assessed with the HCL-32,and their general data also was collected (gender, age, age of first onset, duration, family history,personality and type of temperament, and psychopathology). And patients also were assessed with Chinese Advice Diagnostic Criteria of Soft Bipolar (CADCSB) and loose CADCSB ( Depression with family history of bipolar disorder, or depression with extra personality or hyperthymia or cyclothymia). Results The mean score of the HCL-32 in this samples was (5.7 ±4.7) with range of 19(highest)to 0. There were higher HCL-32 scores in 15 soft bipolar than 113 no-soft bipolar patients (9.4 ±6.7,5.2 ±4.2,t =3.40,P=0.001), in 50 loose CADCSB than 78 no-loose CADCSB patients (7.8 ±5.6,4.3 ±3.4,t =4.34,P =0.000) ,and in 9 depressive patients with bipolar family history ( 9.2 ± 6.8,5.4 ± 4.4, t = 2.39,P = 0.018 ), 9 depressive patients with switching history ( 8.6 ± 7.3,5.3 ± 4.3, t = 2.05, P = 0.043 ),17 depressive patients with cyclothymia or extra personality ( 8.4 ± 5.7,5.3 ± 4.4, t = 2.58, P = 0.011 ),22 depressive patients with hyperthymia ( 9.0 ± 6.7,5.0 ± 3.9, t = 3.90, P = 0.000 ), 11 depressive patients with borderline personality disorder(8.6 ±4.3,5.4 ±4.7,t =2.22,P =0.028), 17 depressive patients with intermittent episode (8.9 ±5.7,5.2 ±4.3 ,t =3.19,P =0.002) than their respective controls. The HCL-32 of male patients was significantly higher than that of female patients ( 4.3 ± 3.7,6.6 ± 5.1, t = 2.87,P =0.005 ). There was no difference in HCL-32 scores between patients with and without depression family history, patients with and without suicide family history, and ones with younger first onset age than older 25 years old, ones with and without atypical depression, patients with and without psychomotor retardation,patients with and without psychotic symptoms, and ones with and without biological rhythm. In all the patients, 37 were with HCL-32 score of 7 or over, 17 with 10 or over and 7 with 14 points or over. The rate of patients with HCL-32 score of 10 or over was similar to the rate of patients with soft bipolar in this sample.Conclusion The HCL-32 could be helpful to screen out possible bipolar disorder in depressive patients. Key words: Depressive disorder;  Bipolar disorder;  Hypomania check list-32