Exploration of the psychometric properties of the 33-item Hypomania Checklist - external assessment (HCL-33-EA)

Abstract

Background: Misdiagnosis of bipolar disorder (BD) is common in clinical practice, leading to inappropriate treatment and detrimental consequences. The 33-item Hypomania Checklist (HCL-33) is a newly developed screening instrument for hypomanic symptoms in patients with BD. The 33-item Hypomania Checklist-external assessment (HCL-33-EA) is a version of the HCL-33 for carers of patients with mood disorders. In this study, the psychometric properties of the HCL-33-EA in a Chinese population were explored.

Method: A total of 182 inpatients and 240 carers were recruited in this study. Patients were diagnosed with bipolar depression or major depressive disorder (MDD) according to the International Classification of Diseases (ICD-10). The patients completed the HCL-33, while their carers filled out the HCL-33-EA.

Results: The HCL-33-EA showed high internal consistency (Cronbach's alpha = 0.876) with two-factorial dimensions. Paired samples t-test revealed that the mean score of the HCL-33-EA was significantly lower than that of the HCL-33 (t = 10.1, p < 0.001). Spearman's rho showed that the two instruments were significantly and positively correlated (r = 0.46, p < 0.001).

Conclusion: The HCL-33-EA has acceptable psychometric properties and could be an effective screening tool for patients' carers, enabling identification of the symptoms of hypomania.

Keywords: Bipolar disorder; China; External assessment; HCL-33; Screening.