Mood Disorder Questionnaire (MDQ)

The Mood Disorder Questionnaire (MDQ) was created by Hirschfeld and colleagues (2000) to address the need for accurately screening individuals with a bipolar spectrum disorder. Accurate identification of bipolar disorder (BD) is of concern as it’s often unrecognised or inaccurately diagnosed, which results in a delay of diagnosis and appropriate treatment (Lish, et al., 1994). Items on the MDQ are derived from the DSM-IV criteria and experience as a clinician (Hirschfeld, 2000).

Clinical Use

Self-report format, around five minutes to complete, not to be used for diagnostic purposes, only as a screening tool, and a comprehensive evaluation should follow a positive screen outcome.

Administration and Scoring

The MDQ consists of 3 questions. First, there are 13 items that examine manic symptoms. Second and third, enquires whether these symptoms identified have co-occurred, and the severity of the symptoms. To screen positive, the individual must have answered ‘yes’ to a minimum of 7 items on question 1, responded ‘yes’ to question 2, and answered ‘moderate problem’ or ‘serious problem’ to question 3.

Development and Psychometric Properties

The MDQ has achieved adequate internal consistency with a Cronbach’s alpha of 0.79 and 0.90 (Hirschfeld, 2000; Isometsä et al., 2003). The validation study administered the MDQ to patients at five psychiatric clinics in the United States (Hirschfeld, 2000). The results were used to determine cut off points for items, specificity, and sensitivity. Findings demonstrated that the MDQ had a 0.73 sensitivity and a 0.90 specificity when contrasted against other screening questionnaires in psychiatric settings. The researchers then conducted testing in a general population, which identified a 0.28 sensitivity and a 0.97 specificity (Hirschfeld, 2002). An additional study assessed the effectiveness of the MDQ in unipolar and bipolar depressive patients and found a 0.58 sensitivity (higher sensitivity for bipolar 1) and a 0.67 specificity (Miller, Klugman, Berv, Rosenquist, Ghaemi, 2004). Lastly, testing in a primary care setting revealed a 0.58 sensitivity and a 0.93 specificity (Hirschfeld, Cass, Holt, Carlson, 2005).

In sum, the MDQ is a useful screening tool for BD, demonstrating validity in clinical settings and across cultures. However, consideration should be given towards its higher sensitivity to detect BD type 1 compared to other BD on the spectrum, and its low sensitivity in general populations. Additionally, the use of differing cutoff points of items in scoring (e.g., standard or modified cutoff value of 7 for question 1), and the inclusion/exclusion criteria (e.g., more defined BD definition/criteria includes more severe cases, and increases sensitivity) has shown variability in sensitivity and specificity thus, limiting its overall effectiveness (Wang, et al., 2015).


1. Has there ever been a period of time when you were not your usual self and...
… You felt so good or hyper that other people thought you were not your normal self or were so hyper that you got into trouble?
... You were so irritable that you shouted at people or started fights or arguments?
... You felt much more self-confident than usual?
... You got much less sleep than usual and found you didn’t really miss it?
... You were much more talkative or spoke much faster than usual?
Thoughts raced through your head or you couldn’t slow your mind down?
... You were so easily distracted by things around you that you had trouble concentrating or staying on track?
... You had much more energy than usual?
... You were much more active or did many more things than usual?
... You were much more social or outgoing than usual‚ for example‚ you telephoned friends in the middle of the night?
... You were much more interested in sex than usual?
... You did things that were unusual for you or that other people might have thought were excessive‚ foolish‚ or risky?
Spending money got you or your family into trouble?
2. If you checked YES to more than one of the above‚ have several of these ever happened during the same period of time?
3. How much of a problem did any of these cause you? Like being unable to work; ha‎ving family‚ money or legal troubles; getting into arguments or fights?
No Problem‚ Minor Problem‚ Moderate Problem‚ Serious Problem
4. Have any of your blood relatives (i.e. Children‚ siblings‚ parents‚ grandparents‚ aunts‚ and uncles) had manic-depressive illness or bipolar disorder?
5. Has a health professional ever told you that you have manic-depressive illness or bipolar disorder?
 
Yes‚ No
This instrument can be found online at: http://www.dbsalliance.org/pdfs/MDQ.pdf
 

Hirschfeld‚ Robert M.‚ Williams‚ Janet B.‚ Spitzer‚ Robert L.‚ Calabrese‚ Joseph R.‚ Flynn‚ Laurie Keck‚ Paul E .‚ Lewis‚ Lydia.‚  McElroy‚ Susan L.‚ Post‚ Robert M.‚ Rapport‚ Daniel J.‚ Russell‚ James M.‚ Sachs‚ Gary S.‚ Zajecka‚ John . (2000). “Development and Validation of a Screening Instrument for Bipolar Spectrum Disorder: The Mood Disorder Questionnaire.” American Journal of Psychiatry 157(11); 1873-1875.

Hirschfeld RM. (2000). The mood disorder questionnaire: simple‚ patient- rated screening for bi- polar disorder. Journal of clinical Psychiatry primary care companion‚ 4; 9-11.

Hirschfeld‚ R.M.‚ Holzer‚ C.‚ Calabrese‚ J.R.‚ Weissman‚ M.‚ Reed‚ M.‚ Davies‚ M‚ et al. (2003). Validity of the mood disorder questionnaire: a general population study. American Journal of Psychiatry 160(1): 178-80.

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Hirschfeld RMA‚ Vornik LA. (2004). Course and treatment of bipolar depression. In: Bowden CL‚ editor. Diagnosis and management of bipolar disorders. London (UK): Science Press; 2004. p. 28 – 40.

Hirschfeld‚ R.M.‚ et al. (2005). Screening for bipolar disorder in patient treated for depression in Family medicine clinic. Journal of the American Board of Family medicine‚ 18(4); 233-239.