Mood Disorder Questionnaire MDQ
Mood Disorder Questionnaire MDQ overview
Creator and Context
The Mood Disorder Questionnaire (MDQ) is a brief self report screening instrument for bipolar spectrum disorder.
It was developed by Robert Hirschfeld and colleagues and published in 2000. Copyright is held by the University of Texas Medical Branch. The instrument states plainly that it is designed for screening purposes only and is not to be used as a diagnostic tool.
Presenting Conditions
The MDQ screens for a lifetime history of manic or hypomanic symptoms. It has three scored parts:
13 yes or no items covering symptoms such as elevated mood, reduced need for sleep, racing thoughts, increased activity and risk taking
A question about whether several of those symptoms occurred during the same period
A question about the level of problem the symptoms caused
Two further questions on family history and prior diagnosis are collected but are not part of the scoring algorithm.
Administration
Self administered in about 5 minutes. The 13 symptom items ask whether there has ever been a period when the person was not their usual self and experienced each symptom, so the recall window is lifetime.
Desired Audience
Adults. A separate parent report adolescent version, the MDQ-A, exists as a distinct instrument.
Bipolar disorder is routinely misdiagnosed as unipolar depression, often for years, because people present when they are depressed and rarely volunteer a history of hypomania. The MDQ is a short, structured way of asking the question that would otherwise not get asked.
Considerations
It is a screen, not a diagnosis. A positive result should lead to a full diagnostic assessment.
Sensitivity is heavily setting dependent. It was 0.73 in psychiatric outpatients but only 0.28 in a general population sample, with specificity of 0.97. It is a poor case finder outside psychiatric settings.
All three scoring conditions must be met. A high symptom count alone is not a positive screen.
Family history and prior diagnosis questions must not be folded into the pass or fail logic.
How to score the Mood Disorder Questionnaire MDQ
Conducting the assessment
The person answers 13 yes or no symptom items, one co occurrence question, and one question about the level of problem the symptoms caused.
Interpretation
A positive screen requires all three of the following:
Yes to 7 or more of the 13 symptom items
Yes to the question about several symptoms occurring during the same period
A rating of Moderate or Serious on the functional impairment question
There is no total severity score and no severity bands. The result is a positive or negative screen.
Clinical Considerations
Use it where the base rate justifies it. In psychiatric and mood services it performs well. In general population screening it misses most true cases.
A positive screen is a prompt for a structured diagnostic interview, particularly to establish whether hypomanic episodes meet duration criteria.
A negative screen in someone with recurrent, early onset or treatment resistant depression does not rule out bipolarity.
Mood Disorder Questionnaire MDQ use cases
Screening for bipolar spectrum disorder in people presenting with depression
Prompting a fuller diagnostic assessment where hypomania may have been missed
Intake screening in psychiatric and specialist mood services
Category
Depression
Research Summary
Hirschfeld, R. M. A., Williams, J. B. W., Spitzer, R. L., et al. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire. American Journal of Psychiatry, 157(11), 1873 to 1875.
Hirschfeld, R. M. A., Holzer, C., Calabrese, J. R., et al. (2003). Validity of the Mood Disorder Questionnaire: A general population study. American Journal of Psychiatry, 160(1), 178 to 180.
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Note on Assessment licensing
Some assessments are copyright protected and require a licence or the copyright holder's permission for clinical, commercial or digital use. Where that applies, obtaining and maintaining that permission is the responsibility of the practice or organisation using the assessment. Tacklit provides the digital administration, scoring and reporting. We do not grant, transfer or supply rights to the underlying instrument.
