The feasibility of screening for suicidal risk with the Hypomania Checklist and Mood Disorder Questionnaire

Abstract

Objective To evaluate the feasibility of screening for suicidal risk with the Hypomania Checklist (HCL-32) and Mood Disorder Questionnaire (MDQ) among patients of bipolar disorder or depression. Methods This was the re-analysis of data from Bipolar Screening Investigation Project.1487 consecutive subjects with bipolar disorder or depression were screened for suicidal ideation using the Chinese version of the HCL-32 and the MDQ,and diagnostically interviewed with the MINI-SCID by physician.According to the MINI-SCID screening for suicide risk,four risk groups were divided.The correlated items of suicide risk were screened in the HCL-32 and MDQ. Results In the 1478 screened patients,ones with non-,low-,middle-or high-suicide risk were 692 (46.8%),271 (18.3%),284 (19.2%) or 231 (15.6%) respectively.The scores of HCL-32 and MDQ in the four groups were significantly different (P 0.05).With logistic regression analysis,factors of suicidal risk were screened with the 1th,29th,31thand 32thitems of HCL-32,i.e.,a decreased need for sleep,increased demand of coffee,alcohol and drugs.The other was with 2th,4thand 13thitems of MDQ,i.e.,tend to lose temper and wrangle,decreased need for sleep,extravagancy.The comparison with the MDQ and HCL-32 performance showed that both screening tools might show passable effects in bipolar disorder with the area under ROC (0.66,0.62). Conclusion The results indicate passable accuracy of HCL-32 and MDQ as a screening instrument for suicide risk with bipolarⅠdisorder,but with a high rate of false negatives of identification for suicide risk in bipolar disorderⅡ. Key words: Suicide; Bipolar disorder; Depressive disorder; The Hypomania Checklist; The Mood Disorder Questionnaire