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Major Mood Disorders
Published in Dr. Ather Muneer, Mood Disorders, 2018
Hypomania is an under-recognized mood state but is, nonetheless, common. Patients do not always recall or read their mood accurately nor judge its consequences, and sometimes enjoy the mood state and view it as desirable. However, hypomania often heralds a manic or depressive episode, with ensuing severe consequences. Although patients typically struggle with depression, families and close associates often complain about the problematic outcomes of hypomanic episodes. Thus, the clinician must be on the lookout for hypomanic symptoms and should not let subtle changes in mood go unrecognized. In the clinical setting both history and mental state examination are helpful in this regard. However, a psychometric scale with good specificity and sensitivity can be invaluable and provides a measure of objectivity to the diagnostic process. In day-to-day practice, an instrument with such attributes is the Hypomania Checklist 32 (HCL-32), which is employed for the screening of hypomanic symptoms in patients with major depression.33 Easily administered, HCL-32 is helpful in diagnosing bipolarity in MDD subjects who experience subclinical symptoms and have never experienced full-fledged manic episodes. There is a caveat, all elements of assessment such as longitudinal course, family history and treatment response must be taken into account to correctly diagnose a depressed patient with bipolar spectrum disorders. Once a diagnosis of hypomania is made, other scales such as the Young Mania Rating Scale can be used to assess the severity of mood elevation.
Can circadian rhythm predict changes in neurocognitive functioning in bipolar disorder: protocol of a 12-month longitudinal cohort study based on research domain criteria
Published in Annals of Medicine, 2023
Huirong Luo, Xueqian Wang, Yinlin Zhang, Junyao Li, Renqin Hu, Zheng Zhang, Qian Liao, Xiaoxin Zhou, Wei Deng, Jian Yang, Qinghua Luo
Secondly, this study is not a randomized controlled study, and a lot of facts might add bias to this study. This is a single-center study, and most patients will be recruited from our Bipolar Disorder Specialist Clinic, which is less presentative of real-world situations and might decrease the diversity of treatment procedures and medications. Moreover, to strengthen the validity and reliability of data, we minimized the amount of self-rating questionnaires, thus impeding more involvement of useful questionnaires such as the Athens Insomnia Scale, Biological Rhythms Interview of Assessment in Neuropsychiatry, 32-item Hypomania Checklist, Patient Health Questionnaire-9 and General Anxiety Disorder-7 [60,70–73]. Nevertheless, we argue that this is only an exploratory study. More strict study conditions could be set and adapted based on this small-sample study results.
Improving Knowledge and Increasing Use of a Screening Tool in an Outpatient Psychiatric Clinic
Published in Issues in Mental Health Nursing, 2020
Mary Kiesewetter, Marsha Snyder, Suzanna Kitten
Multiple search engines were used to conduct the search, including CINAHL, Cochrane, and PsycArticles. Search terms used include combinations of assessment tool, psychiatric setting, hypomania checklist, HCL-32, Bipolar, validity, and reliability. Approximately 15 searches were conducting using combinations of the listed terms. Literature was excluded that was not initially written in English to avoid errors resulting from misinterpretation, as well as literature published prior to 2008, to include the most up to date research. Literature was included that either explored reliable assessment techniques for BD or explored validity or reliability of the HCL-32, and that compared validity and reliability of the HCL-32 to other assessment tools.
Objective and biological markers in bipolar spectrum presentations
Published in Expert Review of Neurotherapeutics, 2019
Trisha Chakrabarty, Lakshmi N. Yatham
Though again few in number, imaging studies of BSPs broadly indicate dysfunction in frontal and subcortical regions. In a resting state comparison of MDD patients scoring high versus low on the Hypomania Checklist (a screening tool for lifetime hypomanic symptomatology), differences in regional homogeneity were found in the superior frontal and middle temporal cortices between the two groups [78]. Two studies also associated dimensional measures of bipolarity to changes in striatal/limbic activation and connectivity. The bipolarity index (a dimensional measure of bipolar traits) was correlated with increased putamen/insula resting state activity in a mixed sample of youth with BDI and MDD diagnoses [79]. In adolescents with diagnoses of ADHD, bipolar spectrum (DSM-IV-TR defined BDI, BDII or BD-NOS), MDD, and anxiety, increased mania scores across all groups was associated with decreased connectivity between the amygdala and insula/putamen [80]. Contrastingly, in a study using the same population as above, no association was found between amygdala-vlPFC connectivity and dimensional measures of mania in youth with ADHD and bipolar spectrum diagnoses [81].