Compared with placebo acupuncture, electroacupuncture and minimal acupuncture resulted in greater improvement in subjective sleep measures at 1 week and 4 week post-treatment. No significant difference was found between electroacupuncture and minimal acupuncture, suggesting that the observed differences could be due to nonspecific effects of needling, regardless of whether it is done according to traditional Chinese medicine theory.

Aims:The aim of the present study was to determine the validity of a Chinese version of the Mood Disorder Questionnaire (MDQ) as a screening instrument for bipolar disorder in a psychiatric outpatient population in Hong Kong.Methods: A total of 185 patients primarily being treated for mood disorders were asked to fill in the Chinese MDQ and supply other personal data during their scheduled clinic visit. The mean age was 43.0 years and 65.9% were female. A subsample of 102 randomly selected subjects, stratified by the MDQ symptom score, received a telephone-based Structured Clinical Interview for DSM-IV (SCID). Sixtytwo patients (60.8%) were suffering from bipolar disorder (bipolar I, n = 48; bipolar II, n = 9; bipolar disorder not otherwise specified, n = 5), 35 (34.3%) from depressive disorder, and one (1.0%) from substance dependence, while four (3.9%) were unaffected by either mood or alcohol/substance use disorder. The internal consistency, factor structure and operating characteristics of the Chinese MDQ were analyzed. Results:The internal consistency of the Chinese MDQ, evaluated using Cronbach alpha, was 0.82. Principal component analysis with varimax rotation indicated an 'energized-activity' factor and an 'irritability-racing thoughts' factor, which explained 47.2% of the rotated variance. The optimal cut-off was seven or more manic symptoms occurring within the same time period, which yielded a sensitivity of 0.73 and a specificity of 0.88 for detecting bipolar disorder. An additional criterion that the symptoms cause impairment resulted in significant loss of sensitivity. Conclusion:The Chinese MDQ is a valid screening instrument for bipolar disorder in a psychiatric outpatient population.

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Bipolar disorder is often unrecognised and misdiagnosed in the general psychiatric setting. This study compared the psychometric properties of the Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32), examined the clinical predictors of bipolar disorder and determined the best approach for screening previously unrecognised bipolar disorder in a general psychiatric clinic. A random sample of 340 non-psychotic outpatients with no previous diagnosis of bipolar disorder completed the MDQ and HCL-32 during their scheduled clinic visits. Mood and alcohol/substance use disorders were reassessed using a telephone-based Structured Clinical Interview for DSM-IV. We found that the HCL-32 had better psychometric performance and discriminatory capacity than the MDQ. The HCL-32's internal consistency and 4-week test-retest reliability were higher. The area under the curve was also greater than that of the MDQ at various clustering and impairment criteria. The optimal cut-off of the MDQ was co-occurrence of four symptoms with omission of the impairment criterion; for the HCL-32, it was 11 affirmative responses. Multivariable logistic regression found that bipolar family history was associated with an increased risk of bipolar disorder (odds ratio=4.93). The study showed that simultaneous use of the HCL-32 and bipolar family history was the best approach for detecting previously unrecognised bipolar disorder.

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