Validation of Shortened Versions of the Lebanese Arabic Hypomania Checklist (HCL-32) for Identifying Bipolar Disorder
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By
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Josleen Al Barathie
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Melissa Barakat
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Elie Hantouche
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George E. Karam
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Elie G. Karam
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May 20, 2026
Clinical Scorecard: Validation of Shortened Versions of the Lebanese Arabic Hypomania Checklist (HCL-32) for Identifying Bipolar Disorder
At a Glance
| Category | Detail |
|---|
| Condition | Bipolar Disorder (BD) |
| Key Mechanisms | Differentiation between BD and Major Depressive Disorder (MDD) using hypomanic symptom assessment. |
| Target Population | Clinically diagnosed patients with BD and MDD in Lebanon. |
| Care Setting | Clinical settings for mental health assessment. |
Key Highlights
- Shortened HCL versions (HCL-20, -16, -8) show strong reliability (α=0.78-0.90).
- Good screening ability (AUC=0.8520-0.8835) for differentiating BD from MDD.
- HCL-16 is identified as the most optimal shortened scale for BD versus MDD.
Guideline-Based Recommendations
Diagnosis
- Utilize HCL-16 for effective screening of BD in clinical settings.
Management
- Consider the risk of misdiagnosis of BD as MDD and adjust treatment accordingly.
Monitoring & Follow-up
- Regularly assess mood fluctuations and hypomanic symptoms in patients.
Risks
- Undiagnosed BD can lead to worsened prognosis and increased risk of suicide.
Patient & Prescribing Data
Patients diagnosed with BD-I, BD-II, and MDD.
Early identification of BD can improve treatment outcomes and reduce misdiagnosis.
Clinical Best Practices
- Incorporate shorter screening tools like HCL-16 in routine assessments.
- Educate clinicians on the differences between BD and MDD to reduce misdiagnosis.
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