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. 2023 Jan 26;23(1):70.
doi: 10.1186/s12888-023-04529-x.

Accuracy of the Arabic HCL - 32 and MDQ in detecting patients with bipolar disorder

Uta Ouali  1   2   3 , Yosra Zgueb  4   5   6 , Lamia Jouini  7 , Amina Aissa  1   2   3 , Rabaa Jomli  1   2   3 , Abdelhafidh Ouertani  1   3 , Adel Omrani  8 , Fethi Nacef  1   2   3 , Mauro G Carta  9 , Antonio Preti  10
Affiliations

Accuracy of the Arabic HCL - 32 and MDQ in detecting patients with bipolar disorder

Uta Ouali et al. BMC Psychiatry. .

Abstract

Background: Studies about the two most used and validated instruments for the early detection of Bipolar Disorder (BD), the 32 - item Hypomania Checklist (HCL - 32) and the Mood Disorder Questionnaire (MDQ), are scarce in non-Western countries. This study aimed to explore the reliability, factor structure, and criterion validity of their Arabic versions in a sample of Tunisian patients diagnosed with mood disorders.

Methods: The sample included 59 patients with BD, 86 with unipolar Major Depressive Disorder (MDD) and 281 controls. Confirmatory factor analysis was applied to show that a single global score was an appropriate summary measure of the screeners in the sample. Receiver Operating Characteristic analysis was used to assess the capacity of the translated screeners to distinguish patients with BD from those with MDD and controls.

Results: Reliability was good for both tools in all samples. The bifactor implementation of the most reported two-factor model had the best fit for both screeners. Both were able to distinguish patients diagnosed with BD from putatively healthy controls, and equally able to distinguish patients diagnosed with BD from patients with MDD.

Conclusion: Both screeners work best in excluding the presence of BD in patients with MDD, which is an advantage in deciding whether or not to prescribe an antidepressant.

Keywords: Bipolar disorder; Depression; Hypomania; Hypomania check list (HCL - 32); Mood disorder questionnaire (MDQ); Screening.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Receiver operator characteristic (ROC) curve of the predictive capacity of the Tunisian MDQ (on the left) and the Tunisian arabic HCL-32 (on the right) in differentiating patients with BD from healthy controls. Sensitivity and specificity are reported as percentages, with a cross indicating on the curve the best compromise between them (corresponding to the cut-off). The area under the ROC curve (AUC) is reported alongside its 95% confidence interval
Fig. 2
Fig. 2
Receiver operator characteristic (ROC) curve of the predictive capacity of the Tunisian MDQ (on the left) and the Tunisian arabic HCL-32 (on the right) in differentiating patients with BD from patients with MDD. Sensitivity and specificity are reported as percentages, with a cross indicating on the curve the best compromise between them (corresponding to the cut-off). The area under the ROC curve (AUC) is reported alongside its 95% confidence interval
Fig. 3
Fig. 3
Comparison with the Hanley and McNeil’s test between the Tunisian arabic MDQ and the Tunisian arabic HCL-32 in distinguishing patients with BD from putatively healthy controls (on the left), or from patients with MDD (on the right)
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