{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T10:41:39Z","timestamp":1792233699940,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,7,12]],"date-time":"2013-07-12T00:00:00Z","timestamp":1373587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>There is mounting evidence that current diagnostic systems inadequately recognize clinically relevant levels of hypomania in depressed patients, thereby leading to an under\u2010diagnosis of bipolar disorders and the associated risk of treatment that is inappropriate or may actually worsen illness course. The Hypomania Checklist\u201332 revised version 2 (<jats:styled-content style=\"fixed-case\">HCL<\/jats:styled-content>\u201032\u2010R2) is a self\u2010rating scale for hypomanic symptoms specifically developed to address this problem. The goal of this study was to assess the transcultural validity of the <jats:styled-content style=\"fixed-case\">HCL<\/jats:styled-content>\u201032\u2010R2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Measurement invariance of <jats:styled-content style=\"fixed-case\">HCL<\/jats:styled-content>\u201032\u2010R2 responses from the multinational Bipolar Disorders: Improving Diagnosis, Guidance, and Education (<jats:styled-content style=\"fixed-case\">BRIDGE<\/jats:styled-content>) Study of 5635 patients with major depressive episodes (<jats:styled-content style=\"fixed-case\">MDE<\/jats:styled-content>s) was assessed by exploratory and confirmatory factor analysis across five cultural regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two previously identified factors were reproduced and explained 60% of the variance in test responses. Only three out of 32 items had cross\u2010culturally variable factor loadings. Some moderate measurement invariance was also found with regard to age and gender. In discriminating unipolar from bipolar disorder, the <jats:styled-content style=\"fixed-case\">HCL<\/jats:styled-content>\u201032\u2010R2 showed a sensitivity of 82% with a specificity of 57% when current <jats:styled-content style=\"fixed-case\">DMS<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> criteria for bipolar disorder were used, and substantially higher specificity of 73% when evidence\u2010based modified criteria were applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The psychometric properties of the <jats:styled-content style=\"fixed-case\">HCL<\/jats:styled-content>\u201032\u2010R2 were largely culture\u2010independent. This finding replicates that of our previous international study and is a step towards validating the <jats:styled-content style=\"fixed-case\">HCL<\/jats:styled-content>\u201032\u2010R2 as a broadly applicable screening instrument for hypomanic features, facilitating the detection of hidden bipolarity in depressed patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12101","type":"journal-article","created":{"date-parts":[[2013,7,12]],"date-time":"2013-07-12T10:01:47Z","timestamp":1373623307000},"page":"701-712","source":"Crossref","is-referenced-by-count":34,"title":["Transcultural validity of the Hypomania Checklist\u201332 (<scp>HCL<\/scp>\u201032) in patients with major depressive episodes"],"prefix":"10.1111","volume":"15","author":[{"given":"Alex","family":"Gamma","sequence":"first","affiliation":[{"name":"Z\u00fcrich University Psychiatric Hospital Zurich 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