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Comparing the Self- and External Assessment Versions of the HCL-33 as Screening Instruments for Bipolar Disorder in Older Depressed Patients
Zhang, Xinqiao1; Li, Wen2; Zhao, Na3,4,5; Jin, Yu6; Cheung, Teris7; Ungvari, Gabor S.8,9; Cui, Xi Ling10; Wang, Gang1; Xiang, Yu Tao3,4,5; Angst, Jules11
2021-11-15
Source PublicationFrontiers in Psychiatry
ISSN1664-0640
Volume12Pages:727992
Abstract

Objectives: The misdiagnosis of bipolar disorder (BD) as major depressive disorder (MDD) is common in depressed older adults. The self-rated HCL-33 and its external assessment version (HCL-33-EA) have been developed to screen for hypomanic symptoms. This study compared the screening ability of these two instruments to discriminate BD from MDD. Methods: A total of 215 patients (107 with BD and 108 with MDD) and their carers were recruited. Patients and their carers completed the HCL-33 and HCL-33-EA, respectively. The consistency of the total score and the positive response to each item between the two scales was calculated with the intraclass correlation coefficient (ICC) and Cohen's kappa coefficient separately. Receiver operating characteristics (ROC) curves were drawn for both instruments. The optimal cut-off points were determined according to the maximum Youden's Index. The areas under the ROC curve (AUC) of the HCL-33 and HCL-33-EA were calculated separately and compared. The sensitivity and specificity at the optimal cut-off values were also calculated separately for the HCL-33 and HCL-33-EA. Results: The intraclass correlation coefficient (ICC) between the total scores of the HCL-33 and HCL-33-EA was 0.823 (95% CI = 0.774–0.862). The positive response rate on all items showed high agreement between the two instruments. ROC curve analysis demonstrated that the total scores of both HCL-33 and HCL-33-EA differentiated well between MDD and BD, while there was no significant difference in the AUCs between the two scales (Z = 0.422, P = 0.673). The optimal cutoff values for the HCL-33 and HCL-33-EA were 14 and 12, respectively. With the optimal cutoff value, the sensitivities of the HCL-33 and HCL-33-EA were 88.8% and 93.5%, and their specificities were 82.4% and 79.6%. Conclusion: Both the HCL-33 and HCL-33-EA had good screening ability for discriminating BD from MDD in depressed older adults.

KeywordBipolar Disorder Hcl-33 Major Depressive Disorder Older Adults Psychometric Property
DOI10.3389/fpsyt.2021.727992
URLView the original
Indexed BySCIE ; SSCI
Language英語English
WOS Research AreaPsychiatry
WOS SubjectPsychiatry
WOS IDWOS:000725574100001
PublisherFRONTIERS MEDIA SAAVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE CH-1015, SWITZERLAND
Scopus ID2-s2.0-85120438944
Fulltext Access
Citation statistics
Document TypeJournal article
CollectionFaculty of Health Sciences
INSTITUTE OF COLLABORATIVE INNOVATION
Institute of Translational Medicine
DEPARTMENT OF PUBLIC HEALTH AND MEDICINAL ADMINISTRATION
Corresponding AuthorWang, Gang; Xiang, Yu Tao
Affiliation1.The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China
2.Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Shanghai Forensic Service Platform, Academy of Forensic Science, Ministry of Justice, Shanghai, China
3.Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macao
4.Centre for Cognitive and Brain Sciences, University of Macau, Macao
5.Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Taipa, Macao
6.College of Education for the Future, Beijing Normal University, Beijing, China
7.School of Nursing, Hong Kong Polytechnic University, Hung Hom, Hong Kong
8.Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, Australia
9.University of Notre Dame Australia, Fremantle, Australia
10.Department of Business Administration, Hong Kong Shue Yan University, North Point, Hong Kong
11.Zurich University Psychiatric Hospital, Zurich, Switzerland
Corresponding Author AffilicationFaculty of Health Sciences;  University of Macau
Recommended Citation
GB/T 7714
Zhang, Xinqiao,Li, Wen,Zhao, Na,et al. Comparing the Self- and External Assessment Versions of the HCL-33 as Screening Instruments for Bipolar Disorder in Older Depressed Patients[J]. Frontiers in Psychiatry, 2021, 12, 727992.
APA Zhang, Xinqiao., Li, Wen., Zhao, Na., Jin, Yu., Cheung, Teris., Ungvari, Gabor S.., Cui, Xi Ling., Wang, Gang., Xiang, Yu Tao., & Angst, Jules (2021). Comparing the Self- and External Assessment Versions of the HCL-33 as Screening Instruments for Bipolar Disorder in Older Depressed Patients. Frontiers in Psychiatry, 12, 727992.
MLA Zhang, Xinqiao,et al."Comparing the Self- and External Assessment Versions of the HCL-33 as Screening Instruments for Bipolar Disorder in Older Depressed Patients".Frontiers in Psychiatry 12(2021):727992.
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