Psychometric validation of the Chinese version of the Bipolar Disorder Knowledge Scale (BDKS-C) among diverse populations and association with beliefs and attitudes toward people with bipolar disorder and help-seeking attitudes

Limited information is available on the health literacy of bipolar disorder (BD) among various populations, and there is no instrument to measure people's knowledge of BD in China. This study aimed to validate a Chinese version of the Bipolar Disorder Knowledge Scale (BDKS-C), compare knowledge levels of BD across 4 different populations, and further explore attitudes toward people with BD and help-seeking attitudes. An observational study was conducted with a total sample (n = 1315) included 388 healthcare professionals, 491 members of the general population, 376 patients with BD, and 60 family caregivers who completed the BDKS-C, the Beliefs and Attitudes Toward Bipolar Disorder, and the Attitude Toward Seeking Professional Psychological Help-Short Form. Items were removed based on item analysis. Internal consistency, test-retest reliability, content validity, concurrent validity, and criterion validity were tested. Psychometric validation yielded a 19-item BDKS-C with acceptable internal consistency and good test-retest reliability, as well as excellent content validity, concurrent validity, and criterion validity. Evidence suggests that knowledge deficits occur among the elderly, the less educated population, patients with BD, family caregivers, and nonmental health professionals. Participants were unwilling to marry a person with BD (54.15%) or a family history of BD (43.57%). The BDKS-C appears to be a reliable and valid instrument for assessing knowledge levels of BD among various populations in China, which could help develop targeted mental health policies and education programs.