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Background <p>This study aimed to complete the revision of the Hypomania Checklist-32 (HCL-32) and systematically validate its psychometric properties in a sample of mainland Chinese psychiatric inpatients.</p> Methods <p>A total of 519 consecutively recruited psychiatric inpatients were enrolled and completed the Chinese version of the HCL-32, the Generalized Anxiety Disorder-7 scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Symptom Checklist-90 (SCL-90). After quality control, 462 patients with complete and valid assessment data were included in the final statistical analysis.</p> Results <p>(1) The revised Chinese HCL-32 scale (HCL-32-R) comprised 25 items and yielded a stable three-factor structure, namely active/elevated, irritable/distractible, and impulsive/stimulating. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) validated the robustness of this three-factor model. (2) All items demonstrated satisfactory factor loadings and aligned well with their corresponding factor dimensions. The Cronbach’s α coefficient for the full HCL-32-R scale was 0.828, with coefficients of 0.944 for Factor 1, 0.742 for Factor 2, and 0.775 for Factor 3. The scale also exhibited favorable convergent validity, discriminant validity, and known-group discriminative capacity. (3) The total score of HCL-32-R, as well as the scores of Factor 2 and Factor 3, showed significant positive correlations with the total scores of the PHQ-9, GAD-7, and SCL-90 scales. (4) Statistically highly significant differences in HCL-32-R total scores were observed across distinct psychiatric diagnostic categories.</p> Conclusions <p>The majority of psychometric indicators for the revised HCL-32-R meet acceptable psychometric standards. The scale demonstrates preliminary application potential for the assessment of hypomanic symptoms in Chinese psychiatric inpatient populations. However, due to the lack of validated optimal cut-off values, sensitivity and specificity data, and test-retest reliability evidence, HCL-32-R cannot be recommended for routine clinical screening use at this stage, and is only suitable for research-based symptom assessment pending further large-sample validation.</p> Clinical trial number <p>Not applicable.</p>

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Revision of the Hypomania Checklist-32 with a sample of Chinese psychiatric inpatients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月3日

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  • Wei Li,
  • Lu Chen,
  • Jie Zhong

摘要

Background

This study aimed to complete the revision of the Hypomania Checklist-32 (HCL-32) and systematically validate its psychometric properties in a sample of mainland Chinese psychiatric inpatients.

Methods

A total of 519 consecutively recruited psychiatric inpatients were enrolled and completed the Chinese version of the HCL-32, the Generalized Anxiety Disorder-7 scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Symptom Checklist-90 (SCL-90). After quality control, 462 patients with complete and valid assessment data were included in the final statistical analysis.

Results

(1) The revised Chinese HCL-32 scale (HCL-32-R) comprised 25 items and yielded a stable three-factor structure, namely active/elevated, irritable/distractible, and impulsive/stimulating. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) validated the robustness of this three-factor model. (2) All items demonstrated satisfactory factor loadings and aligned well with their corresponding factor dimensions. The Cronbach’s α coefficient for the full HCL-32-R scale was 0.828, with coefficients of 0.944 for Factor 1, 0.742 for Factor 2, and 0.775 for Factor 3. The scale also exhibited favorable convergent validity, discriminant validity, and known-group discriminative capacity. (3) The total score of HCL-32-R, as well as the scores of Factor 2 and Factor 3, showed significant positive correlations with the total scores of the PHQ-9, GAD-7, and SCL-90 scales. (4) Statistically highly significant differences in HCL-32-R total scores were observed across distinct psychiatric diagnostic categories.

Conclusions

The majority of psychometric indicators for the revised HCL-32-R meet acceptable psychometric standards. The scale demonstrates preliminary application potential for the assessment of hypomanic symptoms in Chinese psychiatric inpatient populations. However, due to the lack of validated optimal cut-off values, sensitivity and specificity data, and test-retest reliability evidence, HCL-32-R cannot be recommended for routine clinical screening use at this stage, and is only suitable for research-based symptom assessment pending further large-sample validation.

Clinical trial number

Not applicable.