A multinational study to pilot the modified Hypomania Checklist (mHCL) in the assessment of mixed depression

Guidelines for the recognition and management of mixed depression

“…There are several assessment tools available to aid in the recognition of subthreshold hypomanic symptoms, including: Bipolar Depression Rating Scale (BDRS) 47 Clinician-administered assessment of current symptoms Hypomania Interview Guide (HIG) 48 , 49 Clinician-administered assessment of current symptoms Mini International Neuropsychiatric Interview (M.I.N.I. ) 50 Patient self-report assessing current (hypo)manic symptoms Clinically Useful Depression Outcome Scale with DSM–5 Mixed (CUDOS–M) 51 Patient self-report assessing current (hypo)manic symptoms Hypomania Checklist (HCL–32) 33 , 52 Patient self-report that screens for lifetime (hypo)manic symptoms—this does not assess mixed episodes, and has not been suggested to do so Mood Disorder Questionnaire (MDQ) 53 Patient self-report that screens for lifetime (hypo)manic symptoms Altman Mania Rating Scale 54 Patient self-report assessing current (hypo)manic symptoms …”

“…Most of the correlates listed below are also correlates of unipolar depression with borderline personality disorder MDD with active substance use disorders could inflate rates of false-positive detection of hypo/mania symptoms and requires a careful longitudinal history 46 DMX has been associated with: Family history of bipolar spectrum disorders Suicidality Antidepressant-induced mania Rapid cycling Young age of onset Long duration of illness Poor prognosis Severe depression Antidepressant resistance Females Comorbid anxiety Comorbid substance-use disorder (SUD) Impulse control disorders There are several assessment tools available to aid in the recognition of subthreshold hypomanic symptoms, including: Bipolar Depression Rating Scale (BDRS) 47 Clinician-administered assessment of current symptoms Hypomania Interview Guide (HIG) 48 , 49 Clinician-administered assessment of current symptoms Mini International Neuropsychiatric Interview (M.I.N.I. ) 50 Patient self-report assessing current (hypo)manic symptoms Clinically Useful Depression Outcome Scale with DSM–5 Mixed (CUDOS–M) 51 Patient self-report assessing current (hypo)manic symptoms Hypomania Checklist (HCL–32) 33 , 52 Patient self-report that screens for lifetime (hypo)manic symptoms—this does not assess mixed episodes, and has not been suggested to do so Mood Disorder Questionnaire (MDQ) 53 Patient self-report that screens for lifetime (hypo)manic symptoms Altman Mania Rating Scale 54 Patient self-report assessing current (hypo)manic symptoms Patient self-report that screens for “bipolar spectrum disorder” (which includes bipolar I and bipolar II), and the “probabilistic” approach may help to identify patients who are more likely to have a bipolar spectrum disorder rather than pure unipolar depression (Figure 2) The same factors that indicate bipolarity are also evident in patients with DMX Rule out comorbid conditions that phenotypically overlap with mixed features and/or secondary causes of (hypo)mania, but keep in mind that some secondary causes (e.g., substance use) could be more frequent among individuals with bipolar than unipolar disorder Drug and/or alcohol misuse If comorbid, the mood state will generally precede and significantly outlast the state induced by intoxication or withdrawal, and a diagnosis of bipolar disorder can be made Certain medications e.g., L-dopa and corticosteroids, stimulants Organic conditions Most likely in older patients Caffeine use Infections (HIV, syphilis, other) Multiple sclerosis Traumatic brain injury (TBI), brain l...…”

Comparison of the Emotion Regulation and Temperament Characteristics Between Depressive ?Patients With and Without Mixed Features

“…The Modified Hypomania Checklist (mHCL): Hypomania Checklist (HCL-32) is a self rating screening tool for bipolar disorders via detecting lifetime (hypo) manic symptoms (14). mHCL-32 was adapted from HCL-32 by changing its primary property from a diagnostic screening instrument to a tool to assess for concurrent mixed symptoms of depression (15 (18). The Turkish version of the scale consists of 100 items to determine depressive, hyperthymic, irritable, and anxious temperaments.…”

Screening for bipolar disorders: A public health issue

“…The hypothesis that the screeners are inaccurate is based on research data that can bear a quite different interpretation, namely that screening identifies subthreshold cases on the bipolar spectrum or a spectrum including mixed depression (Altinbas et al 2014), Bipolar II and cyclothymic disorders and other subthreshold bipolar disorders as mentioned in DSM-5 that would not have been identified with an interview such as the SCID (Perugi et al 2011;Carta et al 2015). Bipolar Disorders have been shown to be closely associated with the conditions found among the "false positives" at screening, namely: borderline personality disorders (Friborg et al 2014); phobic disorders (Henry et al 2003;Perroud et al 2007); posttraumatic stress disorder (Quarantini et al 2010, Otto et al 2004); alcohol (Balanzà-Martinez et al 2015) and drug (Yoon et al 2011) use disorders; eating disorders (Alvarez Ruiz et al 2015, Mc Elroy et al 2006; impulse control disorder (Karakus et al 2011), and attention deficit disorder (Jerrel et al 2014).…”