Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2)

Michele Fornaro, Domenico De Berardis, Monica Mazza, Mariachiara Pino, Ettore Favaretto, Fulvio Bedani, Christian Wieser, Luisa Indelicato, Vito Fabio Paternò, Francesca Lo Monaco, Febronia Dugo, Antonio Ventriglio, Sergio Mungo, Valerio Selle, Alessandro Valchera, Mai Elassy, Giovanni Martinotti, Andrea De Bartolomeis, Felice Iasevoli, Carmine TomasettiLivia Avvisati, Sergio Tartaglione, Giampaolo Perna, Carlo Ignazio Cattaneo, Giorgio Consoli, Anna Romano, Alessandro Del Debbio, Matteo Martino, Emanuela Dangelo, Concetta De Pasquale, Ann Sarah Koshy, Jules Angst

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective To assess the psychometric properties of the Italian adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) treatment-seeking outpatients. Methods A back-to-back Italian adaption of the "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" English module of the HCL-32-R2 was administered between March 2013 and October 2014 across twelve collaborating sites in Italy. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. Results In our sample (n=441, of whom, BD-I=68; BD-II=117; MDD=256), using a cut-off of 14 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2-) and "sub-threshold bipolar depression" (HCL-32-R2+) with sensitivity=89% and specificity=79%. Area under the curve was.888; positive and negative predictive values were 75.34% and 90.99% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factor analyses, whereas items n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the scale slightly loaded onto F2 and F1 respectively. Cronbachs α=.88 for F1 and.71 for F2. Limitations No cross-validation with any additional validated screening tool; treatment-seeking outpatient sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, neither record of severity of current MDE. Conclusions Our results seem to indicate fair accuracy of HCL-32 as a screening instrument for BD, though replication studies are warranted.

Original languageEnglish
Pages (from-to)112-120
Number of pages9
JournalJournal of Affective Disorders
Volume178
DOIs
Publication statusPublished - Jun 1 2015
Externally publishedYes

Fingerprint

Bipolar Disorder
Major Depressive Disorder
Diagnostic and Statistical Manual of Mental Disorders
Outpatients
Psychometrics
Italy
Statistical Factor Analysis
Area Under Curve
Psychiatry
Comorbidity
History
Pharmacology
Interviews
Education
Sensitivity and Specificity
Therapeutics

Keywords

  • (HCL-32-R2)
  • 34-item
  • Bipolar disorder
  • Check-List-32 second revision
  • Depression
  • Hypomania
  • Italian

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2). / Fornaro, Michele; De Berardis, Domenico; Mazza, Monica; Pino, Mariachiara; Favaretto, Ettore; Bedani, Fulvio; Wieser, Christian; Indelicato, Luisa; Paternò, Vito Fabio; Lo Monaco, Francesca; Dugo, Febronia; Ventriglio, Antonio; Mungo, Sergio; Selle, Valerio; Valchera, Alessandro; Elassy, Mai; Martinotti, Giovanni; De Bartolomeis, Andrea; Iasevoli, Felice; Tomasetti, Carmine; Avvisati, Livia; Tartaglione, Sergio; Perna, Giampaolo; Cattaneo, Carlo Ignazio; Consoli, Giorgio; Romano, Anna; Del Debbio, Alessandro; Martino, Matteo; Dangelo, Emanuela; De Pasquale, Concetta; Koshy, Ann Sarah; Angst, Jules.

In: Journal of Affective Disorders, Vol. 178, 01.06.2015, p. 112-120.

Research output: Contribution to journalArticle

Fornaro, M, De Berardis, D, Mazza, M, Pino, M, Favaretto, E, Bedani, F, Wieser, C, Indelicato, L, Paternò, VF, Lo Monaco, F, Dugo, F, Ventriglio, A, Mungo, S, Selle, V, Valchera, A, Elassy, M, Martinotti, G, De Bartolomeis, A, Iasevoli, F, Tomasetti, C, Avvisati, L, Tartaglione, S, Perna, G, Cattaneo, CI, Consoli, G, Romano, A, Del Debbio, A, Martino, M, Dangelo, E, De Pasquale, C, Koshy, AS & Angst, J 2015, 'Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2)', Journal of Affective Disorders, vol. 178, pp. 112-120. https://doi.org/10.1016/j.jad.2015.03.001
Fornaro, Michele ; De Berardis, Domenico ; Mazza, Monica ; Pino, Mariachiara ; Favaretto, Ettore ; Bedani, Fulvio ; Wieser, Christian ; Indelicato, Luisa ; Paternò, Vito Fabio ; Lo Monaco, Francesca ; Dugo, Febronia ; Ventriglio, Antonio ; Mungo, Sergio ; Selle, Valerio ; Valchera, Alessandro ; Elassy, Mai ; Martinotti, Giovanni ; De Bartolomeis, Andrea ; Iasevoli, Felice ; Tomasetti, Carmine ; Avvisati, Livia ; Tartaglione, Sergio ; Perna, Giampaolo ; Cattaneo, Carlo Ignazio ; Consoli, Giorgio ; Romano, Anna ; Del Debbio, Alessandro ; Martino, Matteo ; Dangelo, Emanuela ; De Pasquale, Concetta ; Koshy, Ann Sarah ; Angst, Jules. / Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2). In: Journal of Affective Disorders. 2015 ; Vol. 178. pp. 112-120.
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title = "Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2)",
abstract = "Objective To assess the psychometric properties of the Italian adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) treatment-seeking outpatients. Methods A back-to-back Italian adaption of the {"}Bipolar Disorders: Improving Diagnosis, Guidance, and Education{"} English module of the HCL-32-R2 was administered between March 2013 and October 2014 across twelve collaborating sites in Italy. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. Results In our sample (n=441, of whom, BD-I=68; BD-II=117; MDD=256), using a cut-off of 14 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between {"}true unipolar{"} (HCL-32-R2-) and {"}sub-threshold bipolar depression{"} (HCL-32-R2+) with sensitivity=89{\%} and specificity=79{\%}. Area under the curve was.888; positive and negative predictive values were 75.34{\%} and 90.99{\%} respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1={"}hyperactive/elated{"} vs. F2={"}irritable/distractible/impulsive{"}) was preferred using exploratory and confirmatory factor analyses, whereas items n.33 ({"}I gamble more{"}) and n.34 ({"}I eat more{"}) introduced in the R2 version of the scale slightly loaded onto F2 and F1 respectively. Cronbachs α=.88 for F1 and.71 for F2. Limitations No cross-validation with any additional validated screening tool; treatment-seeking outpatient sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, neither record of severity of current MDE. Conclusions Our results seem to indicate fair accuracy of HCL-32 as a screening instrument for BD, though replication studies are warranted.",
keywords = "(HCL-32-R2), 34-item, Bipolar disorder, Check-List-32 second revision, Depression, Hypomania, Italian",
author = "Michele Fornaro and {De Berardis}, Domenico and Monica Mazza and Mariachiara Pino and Ettore Favaretto and Fulvio Bedani and Christian Wieser and Luisa Indelicato and Patern{\`o}, {Vito Fabio} and {Lo Monaco}, Francesca and Febronia Dugo and Antonio Ventriglio and Sergio Mungo and Valerio Selle and Alessandro Valchera and Mai Elassy and Giovanni Martinotti and {De Bartolomeis}, Andrea and Felice Iasevoli and Carmine Tomasetti and Livia Avvisati and Sergio Tartaglione and Giampaolo Perna and Cattaneo, {Carlo Ignazio} and Giorgio Consoli and Anna Romano and {Del Debbio}, Alessandro and Matteo Martino and Emanuela Dangelo and {De Pasquale}, Concetta and Koshy, {Ann Sarah} and Jules Angst",
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month = "6",
day = "1",
doi = "10.1016/j.jad.2015.03.001",
language = "English",
volume = "178",
pages = "112--120",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

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TY - JOUR

T1 - Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2)

AU - Fornaro, Michele

AU - De Berardis, Domenico

AU - Mazza, Monica

AU - Pino, Mariachiara

AU - Favaretto, Ettore

AU - Bedani, Fulvio

AU - Wieser, Christian

AU - Indelicato, Luisa

AU - Paternò, Vito Fabio

AU - Lo Monaco, Francesca

AU - Dugo, Febronia

AU - Ventriglio, Antonio

AU - Mungo, Sergio

AU - Selle, Valerio

AU - Valchera, Alessandro

AU - Elassy, Mai

AU - Martinotti, Giovanni

AU - De Bartolomeis, Andrea

AU - Iasevoli, Felice

AU - Tomasetti, Carmine

AU - Avvisati, Livia

AU - Tartaglione, Sergio

AU - Perna, Giampaolo

AU - Cattaneo, Carlo Ignazio

AU - Consoli, Giorgio

AU - Romano, Anna

AU - Del Debbio, Alessandro

AU - Martino, Matteo

AU - Dangelo, Emanuela

AU - De Pasquale, Concetta

AU - Koshy, Ann Sarah

AU - Angst, Jules

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Objective To assess the psychometric properties of the Italian adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) treatment-seeking outpatients. Methods A back-to-back Italian adaption of the "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" English module of the HCL-32-R2 was administered between March 2013 and October 2014 across twelve collaborating sites in Italy. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. Results In our sample (n=441, of whom, BD-I=68; BD-II=117; MDD=256), using a cut-off of 14 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2-) and "sub-threshold bipolar depression" (HCL-32-R2+) with sensitivity=89% and specificity=79%. Area under the curve was.888; positive and negative predictive values were 75.34% and 90.99% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factor analyses, whereas items n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the scale slightly loaded onto F2 and F1 respectively. Cronbachs α=.88 for F1 and.71 for F2. Limitations No cross-validation with any additional validated screening tool; treatment-seeking outpatient sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, neither record of severity of current MDE. Conclusions Our results seem to indicate fair accuracy of HCL-32 as a screening instrument for BD, though replication studies are warranted.

AB - Objective To assess the psychometric properties of the Italian adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) treatment-seeking outpatients. Methods A back-to-back Italian adaption of the "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" English module of the HCL-32-R2 was administered between March 2013 and October 2014 across twelve collaborating sites in Italy. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. Results In our sample (n=441, of whom, BD-I=68; BD-II=117; MDD=256), using a cut-off of 14 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2-) and "sub-threshold bipolar depression" (HCL-32-R2+) with sensitivity=89% and specificity=79%. Area under the curve was.888; positive and negative predictive values were 75.34% and 90.99% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factor analyses, whereas items n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the scale slightly loaded onto F2 and F1 respectively. Cronbachs α=.88 for F1 and.71 for F2. Limitations No cross-validation with any additional validated screening tool; treatment-seeking outpatient sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, neither record of severity of current MDE. Conclusions Our results seem to indicate fair accuracy of HCL-32 as a screening instrument for BD, though replication studies are warranted.

KW - (HCL-32-R2)

KW - 34-item

KW - Bipolar disorder

KW - Check-List-32 second revision

KW - Depression

KW - Hypomania

KW - Italian

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