Journal Article

Factorial structure and familial aggregation of the Hypomania Checklist-32 (HCL-32): Results of the NIMH Family Study of Affective Spectrum Disorders

Glaus, Jennifer, Cui, Lihong, Van Meter, Anna, Marangoni, Ciro, Merikangas, Kathleen R.

2018

Overview

There is substantial evidence that bipolar disorder (BD) manifests on a spectrum rather than as a categorical condition. Detection of people with subthreshold manifestations of BD is therefore important. The Hypomania Checklist-32 (HCL-32) was developed as a tool to identify such people. The aims of this paper were to: (1) investigate the factor structure of HCL-32; (2) determine whether the HCL-32 can discriminate between mood disorder subtypes; and (3) assess the familial aggregation and cross-aggregation of hypomanic symptoms assessed on the HCL with BD. Ninety-six probands recruited from the community and 154 of their adult first-degree relatives completed the HCL-32. Diagnosis was based on semi-structured interviews and family history reports. Explanatory factor analysis and mixed effects linear regression models were used. A four-factor (“Activity/Increased energy,” “Distractibility/Irritability”, “Novelty seeking/Disinhibition, \"Substance use\") solution fit the HCL-32, explaining 11.1% of the total variance. The Distractibility/Irritability score was elevated among those with BP-I and BP-II, compared to those with depression and no mood disorders. Higher HCL-32 scores were associated with increased risk of BD-I (OR = 1.22, 95%CI 1.14–1.30). The “Distractibility/Irritability” score was transmitted within families (β = 0.15, p = 0.040). However, there was no familial cross-aggregation between mood disorders and the 4 HCL factors. Our findings suggest that the HCL-32 discriminates the mood disorder subtypes, is familial and may provide a dimensional index of propensity to BD. Future studies should explore the heritability of symptoms, rather than focusing on diagnoses. •The Hypomania Checklist-32 (HCL) identifies subthreshold symptoms of bipolar disorder (BD)•Four factors (Activity/Increased Energy, Distractibility/Irritability, Novelty Seeking/Disinhibition, Substance use) fit the HCL•The Distractibility/Irritability score was transmitted within families•The Distractibility/Irritability factor may detect propensity to BD

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adult / Age / Aged / Aged, 80 and over / Anxiety / Bipolar disorder / Bipolar Disorder - diagnosis / Bipolar Disorder - genetics / Bipolar Disorder - psychology / Checklist - methods / Checklist - standards / Child & adolescent psychiatry / Cyclothymic Disorder - diagnosis / Cyclothymic Disorder - genetics / Cyclothymic Disorder - psychology / Depressive Disorder - diagnosis / Depressive Disorder - genetics / Depressive Disorder - psychology / Drug use / Factor Analysis, Statistical / Family - psychology / Female / Humans / Liability / Male / Medical diagnosis / Mental depression / Mental health / Middle Aged / Mood Disorders - diagnosis / Mood Disorders - genetics / Mood Disorders - psychology / National Institute of Mental Health (U.S.) / Psychopathology / Retrospective Studies / Substance-Related Disorders - diagnosis / Substance-Related Disorders - genetics / Substance-Related Disorders - psychology / United States - epidemiology