The 33-item Hypomania Checklist (HCL-33) - a study of the consistency between self - and external assessments in Polish bipolar patients.

OBJECTIVES: The Hypomania Checklist (HCL) has become an important tool for the assessment of hypomanic symptoms in patients with mood disorders and in the general population. The HCL-33 scale, containing 33 symptom items, is a new instrument which, in addition to the self-administered questionnaire, has a version for external rating. The aim of this study is to evaluate the consistency between the self - and external assessments using the HCL-33 in Polish patients with bipolar disorder.

METHODS: The data from 81 euthymic bipolar patients recruited in Poznan and Krakow centers were analyzed. All the patients filled out the HCL-33 questionnaire, and, for each patient, the HCL-33 questionnaire-external assessment was completed by his/her significant other.

RESULTS: Of the 33 symptom items, sufficient agreement (significance of kappa factor < 0.05) was found for 13 out of the 19 questions of the "active/elated" (factor 1) and for all 14 items of the "irritable/risk-taking" (factor 2). Insignificant consistency was found for 6 items of factor 1 and the question regarding the longest period of hypomania. The inter-rater agreement between patient and significant other was not affected by gender, living together or subtype of relationship with the patient.

CONCLUSIONS: The results show significant consistency between self - and external assessments for 27 symptom items (82%) of the HCL-33. The future status of the items showing insufficient consistency should be discussed. Limitation of the study is a small number of subjects recruited from only two centers which may not be representative for the Polish population.