The use of Mood Disorder Questionnaire and Hypomania Checklist-32 for screening bipolar disorder among outpatients diagnosed as major depressive disorder in general hospital

Abstract

Objective To compare the psychometric properties of the Chinese Mood Disorder Questionnaire (MDQ) and the Chinese Hypomania Checklist-32 (HCL-32),and determine the better approach for screening bipolar disorder (BD) among outpatients diagnosed as major depressive disorder (MDD) in general hospital. Methods A total of 1010 outpatients diagnosed as MDD were consecutively examined in 3 general hospitals.The patients′socio-demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure.The MDQ and HCL-32 was self-completed by patients to identify symptoms characteristic of BD.DSM-Ⅳdiagnoses were established using the SCID-I/P (Structured Clinical Interview for DSM-Ⅳ axisⅠ disorders,Research Version for patients). Results 417 of the 1010 patients (41.3%) satisfied DSM-Ⅳcriteria for BD.In ROC curve the optimal cut-off of the HCL-32 was 11 symptoms for differentiating BD from MDD,its corresponding sensitivity,specificity,positive predictive value and negative predictive value was 0.80,0.85,0.79 and 0.84.The optimal cut-off of the MDQ was 4 symptoms,its corresponding sensitivity,specificity,positive predictive value and negative predictive value was 0.46,0.96,0.89,0.72;and with omission of the impairment criterion,it was 4 affirmative responses,the sensitivity and specificity was 0.76 and 0.93. Conclusions The study shows the HCL-32 is the better approach for detecting previously unrecognised bipolar disorder among outpatients diagnosed as major depressive disorder in general hospital. Key words: Bipolar disorder; Depressive disorder; Diagnosis