Hypomania Checklist-32 (HCL-32): A Full Guide for Researchers and Clinicians
Published
The HCL-32 is a 32-item yes/no self-assessment that screens for hypomanic symptoms in depression. Learn its two factors, scoring, languages and reliability.
Introduction
The Hypomania Checklist-32 (HCL-32) is a self-administered questionnaire that identifies and assesses hypomanic symptoms, particularly in patients presenting with major depressive disorder. Jules Angst and eight colleagues published it in 2005. It helps clinicians recognize hypomanic components that may point to bipolar II or other bipolar spectrum disorders.
The original study appeared in the Journal of Affective Disorders and has received more than 1,030 citations. The developers designed the HCL-32 as a multilingual self-assessment screening instrument. This guide covers its structure, scoring, languages, psychometric evidence and limitations.
Key Features of the Hypomania Checklist-32 (HCL-32)
Purpose and Use
The HCL-32 screens for hypomanic symptoms in people with depression. Specifically, it helps clinicians in psychiatric and general medical practice recognize hypomanic components that may indicate bipolar II disorder or other bipolar spectrum disorders.
Target Population
The HCL-32 targets adults aged 18 and older, from young adults (18–24 years) to seniors (65+ years).
Structure
The checklist contains 32 symptom items. Together, they cover changes in energy, activity, mood, sleep, self-confidence, sociability, creativity, productivity, sexual interest, speech, thinking speed, distractibility, impulsivity, risk-taking, irritability, interpersonal conflicts and substance use. Factor analysis identified two main dimensions:
Active/Elated Hypomania: more energy and physical activity, elevated mood, self-confidence, sociability, creativity, more activity planning and improved thinking.Risk-taking/Irritable Hypomania: risk-taking, impatience, irritability, distractibility, racing thoughts and interpersonal conflicts.Additional questions assess the frequency, duration, impact and consequences of hypomanic periods.
Scoring Method
Each of the 32 symptom items is scored yes = 1 (present or typical of the respondent) or no = 0 (absent or not typical).
Total score: the number of endorsed items, from 0 to 32. Higher totals mean more reported hypomanic symptoms.Subscale scores: the sum of items loading above 0.4 on each factor, Active/Elated and Risk-taking/Irritable.Note: the number of items per subscale differed between the Italian and Swedish samples. The Italian analysis used 31 items because of a printing error, whereas the Swedish analysis used all 32.Administration Format
The HCL-32 is self-administered and needs no special training. It takes about 10–15 minutes and uses yes/no responses. Respondents can complete it on paper, online, in an in-person interview, or by phone or video call.
Applications of the Hypomania Checklist-32 (HCL-32)
The HCL-32 serves two main purposes:
Screening: detecting hypomanic symptoms in patients who present with depression.Research: studying hypomania and bipolar spectrum disorders, including comparisons with the Mood Disorder Questionnaire (MDQ).Languages and availability
Researchers have validated the HCL-32 in many languages:
English: the original development studyArabic: a Lebanese Arabic validationMandarin Chinese: a Chinese validation in mood disordersSpanish: a cross-validation with the MDQGerman and Swedish: a study in nonclinical samplesFarsi: a study of its applicability and factor structureBrazilian Portuguese: a reliability and validity studyThe HCL-32 is free for research and educational purposes but may not be used commercially. The University of Zurich holds the copyright.
Reliability and Validity
The HCL-32 is considered highly reliable and valid. The total scale showed a Cronbach's alpha of 0.82 (0.82–0.86 in the original study). The subscales reached 0.83 for Active/Elated and 0.75 for Risk-taking/Irritable hypomania.
Validation studies:
The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients (2005): study linkValidation of the Chinese version of the HCL-32 in patients with mood disorders (2008): study linkThe Farsi version of the HCL-32: applicability and a four-factorial solution (2011): study linkLimitations and Considerations
The HCL-32 has several limitations:
Specificity: although sensitive for distinguishing bipolar disorders from major depressive disorder, its specificity was relatively low.Bipolar subtypes: it could not reliably differentiate bipolar I from bipolar II disorder.Preliminary findings: the original results were preliminary.Self-report and length: it relies on self-report, and its 32 items take longer than very brief screeners.Narrow focus and age: it focuses on hypomanic symptoms in adults.Other Versions And Related Questionnaires
Shorter versions of the checklist include the HCL-8, HCL-16, HCL-20 and HCL-28. In addition, these questionnaires are similar or complementary:
Mood Disorder Questionnaire (MDQ); see also the ResRef guide to the MDQ for Adolescents (MDQ-A)Bipolar Depression Rating Scale (BDRS)Internal State Scale (ISS), version 2For manic symptom severity, see the ResRef guide to the Altman Self-Rating Mania Scale (ASRM)Additional Resources
The original study on PubMed: linkYou can access the HCL-32 as a PDF through this linkFor inquiries, contact the corresponding author, Jules Angst, Zurich University Psychiatric Hospital, Lenggstrasse 31, P.O. Box 1931, 8032 Zurich, Switzerland, at jangst@bli.unizh.ch.Browse more psychiatry questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What is the HCL-32 used for?The HCL-32 screens for hypomanic symptoms, especially in patients presenting with major depressive disorder. It helps clinicians recognize features that may indicate bipolar II or other bipolar spectrum disorders.
How is the HCL-32 scored?Each of the 32 items is answered yes (1) or no (0). The total ranges from 0 to 32, and two subscale scores cover Active/Elated and Risk-taking/Irritable hypomania.
How long does the HCL-32 take?The HCL-32 takes about 10 to 15 minutes. Respondents complete it themselves on paper or online, or answer it in an interview or by phone or video call.
Can the HCL-32 tell bipolar I from bipolar II disorder?No. In the original study it could not reliably differentiate bipolar I from bipolar II disorder, and its specificity was relatively low, so it supports rather than replaces clinical assessment.
A Word from ResRef About the Hypomania Checklist-32 (HCL-32)
The HCL-32 is a self-administered screening questionnaire designed to identify hypomanic symptoms, particularly in patients presenting with major depressive disorder and suspected bipolar spectrum disorders. The original development study demonstrated good internal consistency for the total scale (Cronbach's alpha: 0.82–0.86) and identified two principal symptom dimensions. Although it demonstrated useful sensitivity for distinguishing bipolar disorders from major depressive disorder, its specificity was relatively low, and it could not reliably differentiate bipolar I from bipolar II disorder. The original findings were preliminary.
References
Angst, J., Adolfsson, R., Benazzi, F., Gamma, A., Hantouche, E., Meyer, T. D., Skeppar, P., Vieta, E., & Scott, J. (2005). The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients. Journal of Affective Disorders, 88(2), 217–33. https://doi.org/10.1016/j.jad.2005.05.011Wu, Y. S., Angst, J., Ou, C. S., Chen, H. C., & Lu, R. B. (2008). Validation of the Chinese version of the hypomania checklist (HCL-32) as an instrument for detecting hypo(mania) in patients with mood disorders. Journal of Affective Disorders, 106(1-2), 133–43. https://doi.org/10.1016/j.jad.2007.06.004Haghighi, M., Bajoghli, H., Angst, J., Holsboer-Trachsler, E., & Brand, S. (2011). The Farsi version of the Hypomania Check-List 32 (HCL-32): Applicability and indication of a four-factorial solution. BMC Psychiatry, 11(1). https://doi.org/10.1186/1471-244x-11-14Vieta, E., Sánchez-Moreno, J., Bulbena, A., Chamorro, L., Ramos, J. L., Artal, J., Pérez, F., Oliveras, M. A., Valle, J., Lahuerta, J., & Angst, J. (2007). Cross validation with the mood disorder questionnaire (MDQ) of an instrument for the detection of hypomania in Spanish: the 32 item hypomania symptom check list (HCL-32). Journal of Affective Disorders, 101(1-3), 43–55. https://doi.org/10.1016/j.jad.2006.09.040Soares, O. T., Moreno, D. H., Moura, E. C., Angst, J., & Moreno, R. A. (2010). Reliability and validity of a Brazilian version of the Hypomania Checklist (HCL-32) compared to the Mood Disorder Questionnaire (MDQ). Revista Brasileira de Psiquiatria (Sao Paulo, Brazil: 1999), 32(4), 416–23. https://doi.org/10.1590/s1516-44462010000400015Meyer, T. D., Hammelstein, P., Nilsson, L. G., Skeppar, P., Adolfsson, R., & Angst, J. (2007). The Hypomania Checklist (HCL-32): its factorial structure and association to indices of impairment in German and Swedish nonclinical samples. Comprehensive Psychiatry, 48(1), 79–87. https://doi.org/10.1016/j.comppsych.2006.07.001Al Barathie, J., Barakat, M., Hantouche, E., Karam, G. E., & Karam, E. G. (2026). Detecting bipolarity using the Lebanese Arabic hypomania checklist (HCL-32): validation of shortened HCL versions. Frontiers in Psychiatry, 17. https://doi.org/10.3389/fpsyt.2026.1817223