Researchers believe they have developed a simple test to distinguish between a form of bipolar disorder and depression. Type II bipolar disorder is an underdiagnosed disease which can be easily confused with depression.

Patients with bipolar disorder experience manic or hypomanic episodes (euphoria) and depression. Type II bipolar disorder (hypomanic) patients are especially difficult to diagnose since their manic episodes are not very marked and they are usually diagnosed as depression patients.

Contrarily to what happens in type I bipolar disorder, depressive symptoms and, above all, manic symptoms alternated in this form of the disease are not evident and difficult to identify. In fact, patients suffering from it usually go to the doctor because they are depressed, without thinking that they have also had slight manic episodes (euphoria and other cognition disorders).

According to background information in the article, medical authorities lack tools to successfully identify this pathology, which can take 8-10 years to be correctly diagnosed. Furthermore, antidepressant treatment can be counterproductive in patients with type II bipolar disorder.

Accordingly, a simple tool of 32 questions – called the HCL-32 test has been developed to distinguish major depression from bipolar disorder. The study verifying the questionnaire is published in the Journal of Affective Disorders (PDF of article).

In the study, led by researcher Jules Angst, this test was able to identify more than 80 percent of patients with bipolar disorder. Although the test could not distinguish between types I and II, this decision is relatively easy to take from the clinical data of the patient.

While the test needs to be replicated among patients in wider populations, the HCL-32 test can provide very useful information to psychiatrists and even to primary-care physicians.

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IDIBAPS – Institut d’Investigacions Biomèdiques August Pi i Sunyer