Rev Psiquiatr Salud Ment (Barc.). 2012;5(2):89---97 www.elsevier.es/saludmental ORIGINAL ARTICLE Early detection of hypomania episodes in patients with affective disorder  Inés García-Castillo * , Lidia Fernández-Mayo, Elena Serrano-Drozdowskyij, Rodrigo Carmona, María José Martín-Calvo, Santiago Ovejero, Isabel Millán, Fernando García, Enrique Baca-García Unidad de Psiquiatría, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain Received 6 May 2011; accepted 19 December 2011 Available online 19 June 2012 KEYWORDS Bipolar disorder; HCL-32; Hypomania; Major depression; Prevalence Abstract Introduction: Bipolar disorder (BP) is one of the major causes of disability in the world. Epi- demiological studies suggest that this disorder could be under-diagnosed owing to the difficulty in detecting hypomania episodes. The detection of present and past episodes of hypomania could help in the diagnosis and appropriate treatment of this disorder. The Hypomania Check List (HCL-32) is a questionnaire validated into Spanish and designed to detect past and present hypomania episodes in the psychiatric patient population. Materials and methods: A total of 128 patients over 18 years old and diagnosed with type I bipolar (BP-I) disorder (n = 1), type II bipolar (BP-II) disorder (n = 30), major depression (MD) (n = 57), anxiety disorders (AD) (n = 15) were selected, along with a control group (C) (n = 25). The patients were diagnosed according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IVTR). Screening for hypomania episodes was carried out by applying the HCL-32 scale. Results: The area under the ROC curve was 0.65 with a 95% confidence interval (CI) of 0.55---0.75. The chosen cut-off point of the HCL-32 was 15. The values for the sensitivity (Se), specificity (Sp), positive predictive values (PPV) and negative predictive values (NPV), and the prevalence (P) of hypomania episodes in the patients of the UP depression, for a cut-off point of 15 were: Se = 71.4%, 95% CI; 57.8, 85.1, Sp = 45.8%, 95% CI; 34.5---57.1, PPV = 43.75%, 95% CI; 32.25---55.25, NPV: 73.08%, 95% CI; 60.06---86.09 and P = 67.2%. Conclusions: The HCL-32 is a very sensitive, but not very specific, screening tool. This could partly explain the high proportion of hypomania episodes detected in our sample. Unlike previ- ous studies, our sample is heterogeneous (from different environments) and at a more severe and unstable clinical level. Future research should develop more specific measuring tools, and with greater external validation, for hypomania episodes. © 2011 SEP y SEPB. Published by Elsevier España, S.L. All rights reserved.  Please cite this article as: García-Castillo I, et al. Detección precoz de episodios de hipomanía en pacientes con trastorno afectivo. Rev Psiquiatr Salud Ment (Barc). 2012;5:89---97. ∗ Corresponding author. E-mail address: inesgarciac@hotmail.com (I. García-Castillo). 2173-5050/$ – see front matter © 2011 SEP y SEPB. Published by Elsevier España, S.L. All rights reserved.