Characterization and structure of hypomania in a British nonclinical adolescent sample

Georgina M Hosang,Alastair G Cardno,Daniel Freeman,Angelica Ronald

doi:10.1016/j.jad.2016.08.033

Abstract

BackgroundThis study aimed to test the validity of using the Hypomania Checklist-16 [HCL-16] to measure hypomania in a British adolescent community sample. Limited research is available concerning the characterization of hypomania among community adolescent samples, particularly in the UK, despite its potential importance for early intervention policy development. MethodTo explore the structure and characterization of hypomania in a British adolescent nonclinical cohort, over 1400 17 year olds (Mean=17.05 years; SD=0.88) completed the HCL-16 along with measures of different psychological and psychopathological dimensions. ResultsPrincipal components analysis revealed a 2-component solution for the HCL-16, described as active-elated and irritable/risk-taking. Hypomanic symptoms were significantly correlated with many psychopathological dimensions. There were distinct correlation patterns for the two HCL-16 subscales, with the irritability/risk-taking subscale showing significantly stronger associations with psychotic-like experiences, internalizing and externalizing problems, and reduced life satisfaction relative to the active-elated dimension. Adolescents at ‘high-risk’ for bipolar disorder reported more psychopathology relative to the comparison group. LimitationsAbsence of the clinical diagnosis of bipolar disorder in the sample means that the classification of the ‘high-risk’ group cannot be confirmed. ConclusionsThe structure of the HCL-16 in this UK adolescent sample mirrored that observed in adult and clinical cohorts. The observed links between the HCL-16 and psychopathological dimensions that have been previously associated with both hypomania and bipolar disorder lend support to the HCL-16's validity as a hypomania instrument for adolescents. Better understanding of hypomania prior to adulthood has considerable potential for informing early intervention approaches.

Highlights

The average age of onset for bipolar disorder [BD] ranges from 18 to 22 years (Merikangas et al, 2011), up to 60% of people with BD report their illness onset occurring in childhood or adolescence (Perlis et al, 2009)
This study investigated the structure and characterization of hypomania in a large British adolescent sample
The first objective of this study was to explore the structure of hypomania in a nonclinical sample of British adolescents

Summary

Introduction

The average age of onset for bipolar disorder [BD] ranges from 18 to 22 years (Merikangas et al, 2011), up to 60% of people with BD report their illness onset occurring in childhood or adolescence (Perlis et al, 2009). There is increased interest surrounding pediatric BD, but there is limited research in the UK with the majority of the published work conducted in the US (Skirrow et al, 2012) This means it is unclear whether the findings from US samples are generalizable to the UK and other populations. Method: To explore the structure and characterization of hypomania in a British adolescent nonclinical cohort, over 1400 17 year olds (Mean=17.05 years; SD=0.88) completed the HCL-16 along with measures of different psychological and psychopathological dimensions. Limitations: Absence of the clinical diagnosis of bipolar disorder in the sample means that the classification of the ‘high-risk’ group cannot be confirmed. The observed links between the HCL-16 and psychopathological dimensions that have been previously associated with both hypomania and bipolar disorder lend support to the HCL-16's validity as a hypomania instrument for adolescents. Better understanding of hypomania prior to adulthood has considerable potential for informing early intervention approaches

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Conclusion