Screening for Bipolar Disorder Symptoms in Depressed Primary Care Attenders : Comparison between Mood Disorder Questionnaire and Hypomania Checklist (HCL-32)‎

Abstract EN

Objective.

To describe the prevalence of patients who screen positive for bipolar disorder (BD) symptoms in primary care comparing two screening instruments: Mood Disorders Questionnaire (MDQ) and Hypomania Checklist (HCL-32).

Participants.

Adult patients presenting to their primary care practitioners for any cause and reporting current depression symptoms or a depressive episode in the last 6 months.

Methods.

Subjects completed MDQ and HCL-32, and clinical diagnosis was assessed by a psychiatrist following DSM-IV criteria.

Depressive symptoms were evaluated in a subgroup with the Patient Health Questionnaire (PHQ-9).

Results.

A total of 94 patients were approached to participate and 93 completed the survey.

Among these, 8.9% screened positive with MDQ and 43.0% with HCL-32.

MDQ positive had more likely features associated with BD: panic disorder and smoking habit (P<.05).

The best test accuracy was performed by cut-off 5 for MDQ (sensitivity = .91; specificity = .67) and 15 for HCL-32 (sensitivity = .64; specificity = .57).

Higher total score of PHQ-9 was related to higher total scores at the screening tests (P<.001).

Conclusion.

There is a significant prevalence of bipolar symptoms in primary care depressed patients.

MDQ seems to have better accuracy and feasibility than HCL-32, features that fit well in the busy setting of primary care.