Characterization and Structure of Hypomania in a British Nonclinical Adolescent Sample

Overview

Journal J Affect Disord

Date 2016 Oct 12

PMID 27728870

Citations 3

Authors

Georgina M Hosang

Alastair G Cardno

Daniel Freeman

Angelica Ronald

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to test the validity of using the Hypomania Checklist-16 [HCL-16] to measure hypomania in a British adolescent community sample. Limited research is available concerning the characterization of hypomania among community adolescent samples, particularly in the UK, despite its potential importance for early intervention policy development.

Method: To explore the structure and characterization of hypomania in a British adolescent nonclinical cohort, over 1400 17 year olds (Mean=17.05 years; SD=0.88) completed the HCL-16 along with measures of different psychological and psychopathological dimensions.

Results: Principal components analysis revealed a 2-component solution for the HCL-16, described as active-elated and irritable/risk-taking. Hypomanic symptoms were significantly correlated with many psychopathological dimensions. There were distinct correlation patterns for the two HCL-16 subscales, with the irritability/risk-taking subscale showing significantly stronger associations with psychotic-like experiences, internalizing and externalizing problems, and reduced life satisfaction relative to the active-elated dimension. Adolescents at 'high-risk' for bipolar disorder reported more psychopathology relative to the comparison group.

Limitations: Absence of the clinical diagnosis of bipolar disorder in the sample means that the classification of the 'high-risk' group cannot be confirmed.

Conclusions: The structure of the HCL-16 in this UK adolescent sample mirrored that observed in adult and clinical cohorts. The observed links between the HCL-16 and psychopathological dimensions that have been previously associated with both hypomania and bipolar disorder lend support to the HCL-16's validity as a hypomania instrument for adolescents. Better understanding of hypomania prior to adulthood has considerable potential for informing early intervention approaches.

Citing Articles

ADHD symptom trajectories across childhood and early adolescence and risk for hypomanic symptoms in young adulthood.

Durdurak B, Morales-Munoz I, Morales Munoz I, Hosang G, Marwaha S Eur Psychiatry. 2025; 68(1):e37.

PMID: 39967022 PMC: 11883789. DOI: 10.1192/j.eurpsy.2025.24.

Illuminating Hypomania in Early Adolescence: Associations Between Dark-Side and Bright-Side Hypomania, Insomnia, and Health-Related Quality of Life.

Eisenhut L, Sadeghi-Bahmani D, Dursteler K, Mikoteit T, Fichter C, Bruhl A J Clin Med. 2024; 13(22).

PMID: 39597929 PMC: 11594785. DOI: 10.3390/jcm13226785.

Precursors of self-reported subclinical hypomania in adolescence: A longitudinal general population study.

Nielsen L, Rimvall M, van Os J, Verhulst F, Ulrikka Rask C, Skovgaard A PLoS One. 2021; 16(6):e0253507.

PMID: 34143836 PMC: 8213158. DOI: 10.1371/journal.pone.0253507.

Association of Genetic and Environmental Risks for Attention-Deficit/Hyperactivity Disorder With Hypomanic Symptoms in Youths.

Hosang G, Lichtenstein P, Ronald A, Lundstrom S, Taylor M JAMA Psychiatry. 2019; 76(11):1150-1158.

PMID: 31411648 PMC: 6694400. DOI: 10.1001/jamapsychiatry.2019.1949.

References

Stringaris A, Stahl D, Santosh P, Goodman R . Dimensions and latent classes of episodic mania-like symptoms in youth: an empirical enquiry. J Abnorm Child Psychol. 2011; 39(7):925-37. PMC: 3161193. DOI: 10.1007/s10802-011-9520-8. View

Barnett J, Huang J, Perlis R, Young M, Rosenbaum J, Nierenberg A . Personality and bipolar disorder: dissecting state and trait associations between mood and personality. Psychol Med. 2010; 41(8):1593-604. PMC: 10034850. DOI: 10.1017/S0033291710002333. View

Lund H, Reider B, Whiting A, Prichard J . Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health. 2010; 46(2):124-32. DOI: 10.1016/j.jadohealth.2009.06.016. View

Adelson S, Bell R, Graff A, Goldenberg D, Haase E, Downey J . Is increased sexual behavior a symptom of bipolar disorder in children and adolescents?. Psychodyn Psychiatry. 2013; 41(3):419-35. DOI: 10.1521/pdps.2013.41.3.419. View

Stringaris A, Santosh P, Leibenluft E, Goodman R . Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry. J Child Psychol Psychiatry. 2009; 51(1):31-8. PMC: 4286871. DOI: 10.1111/j.1469-7610.2009.02129.x. View

Youngstrom E, Freeman A, Jenkins M . The assessment of children and adolescents with bipolar disorder. Child Adolesc Psychiatr Clin N Am. 2009; 18(2):353-90, viii-ix. PMC: 2915577. DOI: 10.1016/j.chc.2008.12.002. View

Goodman R . The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997; 38(5):581-6. DOI: 10.1111/j.1469-7610.1997.tb01545.x. View

Meyer T, Hammelstein P, Nilsson L, Skeppar P, Adolfsson R, Angst J . The Hypomania Checklist (HCL-32): its factorial structure and association to indices of impairment in German and Swedish nonclinical samples. Compr Psychiatry. 2006; 48(1):79-87. DOI: 10.1016/j.comppsych.2006.07.001. View

Angst J, Gamma A, Benazzi F, Ajdacic V, Eich D, Rossler W . Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Affect Disord. 2003; 73(1-2):133-46. DOI: 10.1016/s0165-0327(02)00322-1. View

10.

Axelson D, Goldstein B, Goldstein T, Monk K, Yu H, Hickey M . Diagnostic Precursors to Bipolar Disorder in Offspring of Parents With Bipolar Disorder: A Longitudinal Study. Am J Psychiatry. 2015; 172(7):638-46. PMC: 4489996. DOI: 10.1176/appi.ajp.2014.14010035. View

11.

Hafeman D, Axelson D, Demeter C, Findling R, Fristad M, Kowatch R . Phenomenology of bipolar disorder not otherwise specified in youth: a comparison of clinical characteristics across the spectrum of manic symptoms. Bipolar Disord. 2013; 15(3):240-52. PMC: 3644315. DOI: 10.1111/bdi.12054. View

12.

Hanscombe K, Trzaskowski M, Haworth C, Davis O, Dale P, Plomin R . Socioeconomic status (SES) and children's intelligence (IQ): in a UK-representative sample SES moderates the environmental, not genetic, effect on IQ. PLoS One. 2012; 7(2):e30320. PMC: 3270016. DOI: 10.1371/journal.pone.0030320. View

13.

Dunayevich E, Keck Jr P . Prevalence and description of psychotic features in bipolar mania. Curr Psychiatry Rep. 2000; 2(4):286-90. DOI: 10.1007/s11920-000-0069-4. View

14.

McGuffin P, Rijsdijk F, Andrew M, Sham P, Katz R, Cardno A . The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry. 2003; 60(5):497-502. DOI: 10.1001/archpsyc.60.5.497. View

15.

Waugh M, Meyer T, Youngstrom E, Scott J . A review of self-rating instruments to identify young people at risk of bipolar spectrum disorders. J Affect Disord. 2014; 160:113-21. DOI: 10.1016/j.jad.2013.12.019. View

16.

Angst J, Adolfsson R, Benazzi F, Gamma A, Hantouche E, Meyer T . The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients. J Affect Disord. 2005; 88(2):217-33. DOI: 10.1016/j.jad.2005.05.011. View

17.

Skirrow C, Hosang G, Farmer A, Asherson P . An update on the debated association between ADHD and bipolar disorder across the lifespan. J Affect Disord. 2012; 141(2-3):143-59. DOI: 10.1016/j.jad.2012.04.003. View

18.

Perlis R, Dennehy E, Miklowitz D, DelBello M, Ostacher M, Calabrese J . Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study. Bipolar Disord. 2009; 11(4):391-400. PMC: 3992980. DOI: 10.1111/j.1399-5618.2009.00686.x. View

19.

Michalak E, Yatham L, Lam R . Quality of life in bipolar disorder: a review of the literature. Health Qual Life Outcomes. 2005; 3:72. PMC: 1325049. DOI: 10.1186/1477-7525-3-72. View

20.

Mullins-Sweatt S, Jamerson J, Samuel D, Olson D, Widiger T . Psychometric properties of an abbreviated instrument of the five-factor model. Assessment. 2006; 13(2):119-37. DOI: 10.1177/1073191106286748. View