The 33-item Hypomania Checklist (HCL-33) - a study of the consistency between self - and external assessments in Polish bipolar patients.

OBJECTIVES The Hypomania Checklist (HCL) has become an important tool for the assessment of hypomanic symptoms in patients with mood disorders and in the general population. The HCL-33 scale, containing 33 symptom items, is a new instrument which, in addition to the self-administered questionnaire, has a version for external rating. The aim of this study is to evaluate the consistency between the self - and external assessments using the HCL-33 in Polish patients with bipolar disorder. METHODS The data from 81 euthymic bipolar patients recruited in Poznan and Krakow centers were analyzed. All the patients filled out the HCL-33 questionnaire, and, for each patient, the HCL-33 questionnaire-external assessment was completed by his/her significant other. RESULTS Of the 33 symptom items, sufficient agreement (significance of kappa factor < 0.05) was found for 13 out of the 19 questions of the "active/elated" (factor 1) and for all 14 items of the "irritable/risk-taking" (factor 2). Insignificant consistency was found for 6 items of factor 1 and the question regarding the longest period of hypomania. The inter-rater agreement between patient and significant other was not affected by gender, living together or subtype of relationship with the patient. CONCLUSIONS The results show significant consistency between self - and external assessments for 27 symptom items (82%) of the HCL-33. The future status of the items showing insufficient consistency should be discussed. Limitation of the study is a small number of subjects recruited from only two centers which may not be representative for the Polish population.