The HCL-32: its factorial structure and association to indices of impairment in a German and Swedish non-clinical sample

Background. Bipolar disorders are often not recognized. Several instruments were developed but none primarily focused on hypomania. The Hypomania Checklist (HCL) is aimed at the identification of bipolarity in outpatients. Using a German and Swedish sample we investigated if the factor structure in non-clinical samples is similar to the one reported for outpatient samples. Furthermore we tested if people who probably had a lifetime history of hypomania report more depression or other signs of impairment and if current depression is associated with lifetime hypomania. Method. In the German study participants completed the HCL-32 as an online-questionnaire that also included questions about lifetime and current depression (n = 695), while the Swedish data relied on the paper-and-pencil version of the HCL-32 completed by a random sample from a representative population sample (n = 408). Results. The factor structure of the HCL-32 was fairly similar in both samples and to the ones presented by Angst et al. (2005). People reporting ‘highs’ (> 4 days and experiencing negative consequences) not only endorsed more HCL-32 symptoms, but also had higher rates of current and former depression and psychotherapy. Level of current depression was also associated with lifetime hypomanic symptoms Discussion & Limitation. An active-elated and risk-taking/irritable factor of hypomania can be distinguished with the HCL-32 in clinical and non-clinical samples. Based on our results the HCL-32 might even be useful as screening tool in non-clinical samples and not only in depressed outpatients. However, our data do not allow estimating sensitivity and specificity of the HCL-32 because structured clinical interviews were not included TDM/ The HCL-32: its factorial structure... /Version 2.1 3