Spanish Versions of the 32-Item Hypomania Checklist (HCL-32) and the Mood Disorder Questionnaire (MDQ) for bipolar disorder in Outpatients

Background: Bipolar disorder is a chronic mental health condition with high prevalence and significant impact on functioning, frequently leading to delays in accurate diagnosis. Valid screening tools, such as the Hypomania Checklist-32 (HCL-32) and Mood Disorder Questionnaire (MDQ), are essential to improve detection rates. However, limited research exists on the psychometric properties of these instruments in Spanish-speaking populations.Aims. This study examines the psychometric properties of the Spanish versions of the HCL-32 and MDQ in outpatients.Methods: A cross-sectional study was conducted at YACHAY, a mental health clinic in Lima, Peru. Participants completed the PHQ-9, GAD-7, HCL-32, and MDQ.Results: A total of 370 patients were analyzed, with 57.6% female and 42.4% male. The MDQ demonstrated superior psychometric properties compared to the HCL-32, with optimal sensitivity (0.46) and specificity (0.85) at a cutoff of ≥10. In CFA, the bifactor model provided the best fit for both the MDQ (CFI=0.972, TLI=0.958, RMSEA=0.062) and HCL-32 (CFI=0.934, TLI=0.921, RMSEA=0.065). Measurement invariance by gender was confirmed across configural, metric, and scalar models for both scales. The internal consistency was acceptable, with Cronbach's alpha values exceeding 0.70 for both instruments.Conclusions: The Spanish MDQ showed higher diagnostic utility than the HCL-32 for screening bipolar disorder in Peruvian outpatients. These findings suggest that the MDQ, especially with the bifactor model, is an effective tool for detecting bipolar disorder in this context, supporting its use in mental health services across Latin America. Future studies should further explore these instruments' applicability in diverse Latin American populations.