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The development and validation of a short version of the 33-item Hypomania Checklist (HCL-33)
Wang, Yuan-Yuan1; Feng, Yuan2; Xu, Dan-Dan1,3; Huang, Wei4; Chow, Ines H. I.1; Ng, Chee H.5; Ungvari, Gabor S.6; Yuan, Zhen1; Wang, Gang2; Xiang, Yu-Tao3


The misdiagnosis of bipolar disorder (BD) as major depressive disorder (MDD) is common in clinical practice and may result in inappropriate treatment. The 33-item Hypomania Checklist (HCL-33) is a newly developed screening scale for BD with satisfactory psychometric properties. In this study, a short version of the HCL-33 was developed and validated to discriminate between BD and MDD.


All interviews were conducted in a major psychiatric hospital in China. The short version of HCL-33 (the HCL-23) was initially developed using a sample of 186 patients (MDD = 84, BD-I = 46, BD-II = 56) and its performance was tested in a separate sample of 164 patients (MDD = 77, BD-I = 44, BD-II = 43).


The HCL-23 showed high internal consistency (Cronbach's alpha = 0.906) with two-factorial dimensions. Compared to the HCL-33, the HCL-23 demonstrated a marginally weaker performance in terms of sensitivity+specificity (1.38 vs 1.36 for BD vs MDD, 1.33 vs 1.32 for BD-I vs MDD, and 1.44 vs 1.42 for BD-II vs MDD). For discriminating BD, BD-I, and BD-II from MDD, the HCL-23 showed better sensitivity (0.82 vs 0.67, 0.77 vs 0.68, and 0.86 vs 0.72, respectively) than the HCL-33, while the HCL-33 showed better specificity (0.71 vs 0.55, 0.65 vs 0.55, and 0.71 vs 0.56, respectively) than the HCL-23.


Both HCL-33 and HCl-23 have comparable psychometric properties and screening ability for BD. The HCL-23 is an effective screening tool for detecting BD in clinical settings. The HCL-23 was developed in China, therefore its psychometric properties need to be confirmed in different socio-cultural contexts.

KeywordBipolar Disorder Major Depressive Disorder Screening Hcl
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Indexed BySCI ; SSCI ; SSCI
WOS Research AreaNeurosciences & Neurology ; Psychiatry
WOS SubjectClinical Neurology ; Psychiatry
WOS IDWOS:000432686900032
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Document TypeJournal article
CollectionFaculty of Health Sciences
Affiliation1.Faculty of Health Sciences, University of Macau, Macau
2.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
3.Faculty of science, Harbin University, Heilongjiang province, China
4.Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
5.Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
6.University of Notre Dame Australia/Graylands Hospital, Perth, Australia
First Author AffilicationFaculty of Health Sciences
Recommended Citation
GB/T 7714
Wang, Yuan-Yuan,Feng, Yuan,Xu, Dan-Dan,et al. The development and validation of a short version of the 33-item Hypomania Checklist (HCL-33)[J]. JOURNAL OF AFFECTIVE DISORDERS,2018,235:206-210.
APA Wang, Yuan-Yuan.,Feng, Yuan.,Xu, Dan-Dan.,Huang, Wei.,Chow, Ines H. I..,...&Xiang, Yu-Tao.(2018).The development and validation of a short version of the 33-item Hypomania Checklist (HCL-33).JOURNAL OF AFFECTIVE DISORDERS,235,206-210.
MLA Wang, Yuan-Yuan,et al."The development and validation of a short version of the 33-item Hypomania Checklist (HCL-33)".JOURNAL OF AFFECTIVE DISORDERS 235(2018):206-210.
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