The Mood Disorder Questionnaire (MDQ)

Assessment Rating:
A
A – Psychometrics Well-Demonstrated
See entire scale
Developer(s):

Robert M.A. Hirschfeld

Description / Purpose:

The Mood Disorder Questionnaire (MDQ) screens for Bipolar Disorder.

The MDQ is a brief, self-rated screening tool for bipolar disorder developed by a team of psychiatrists, researchers, and consumer advocates. The MDQ screens for bipolar disorder (which includes bipolar I, bipolar II, and bipolar NOS). This questionnaire consists of 13 yes/no items and 2 questions on co-occurrence of symptoms and level of functional impairment. The scale can be completed by patients in about 5 minutes.

Target Population: This scale for validated for use in Adults. There is also a Mood Disorder Questionnaire-Adolescent Version for use in adolescent population.

Time to Administer: 5-10 minutes

Completed By: Self Report

Modalities Available: Print and online

Scoring Information: The scale is hand-scored. A positive screen requires 7 or more “yes” responses, symptom co-occurrence, and moderate-to-severe functional impairment as rated by the patient.

Languages Available: Chinese, Dutch, English, Estonian, Finnish, French, French Canadian, German, Italian, Japanese, Korean, Polish, Slovenian, Spanish, Swedish, Thai, Turkish

Training Requirements for Intended Users: None

Availability: The scale is copyrighted by Dr Robert Hirschfeld, use of the scale requires his written consent.

Contact Information

Name: Robert M.A. Hirschfeld, MD
Email:
Phone: (409) 747-9791
Fax: (409) 747-8300

Summary of Relevant Psychometric Research

This tool has received the Measurement Tools Rating of "A – Psychometrics Well-Demonstrated" based on the published, peer-reviewed research available. The tool must have 2 or more published, peer-reviewed studies that have established the measure’s psychometrics (e.g., reliability and validity, sensitivity and specificity, etc.). Please see the Measurement Tools Rating Scale for more information.

Show relevant research...

Hirschfeld, R.M.A., Williams, J.B., Spitzer, R.L., Calabrese, J.R., Flynn, L., Keck, P.E. Jr., Lewis, L., McElroy, S.L., Post, R.M., Rapport, D.J., Russell, J.M., Sachs, G.S., Zajecka, J. (2000). “Development and Validation of a Screening Instrument for Bipolar Spectrum Disorder: The Mood Disorder Questionnaire”, American Journal of Psychiatry 157(11): 1873-1875

Sample:

Participants — 198 outpatient psychiatric patients

Race/Ethnicity — 90% Caucasian, 9% African American

Summary:

This study assessed the sensitivity and specificity of a brief, self-rated screening instrument for bipolar spectrum Disorder, the Mood Disorder Questionnaire, by using a research diagnostic interview as the standard for diagnosis in a psychiatric outpatient population. The study was conducted at five outpatient psychiatric clinics that primarily treat patients with mood disorders, especially bipolar disorder. Results indicate a Mood Disorder Questionnaire screening score of 7 or more items yielded good sensitivity (0.73) and very good specificity (0.90).

Hirschfeld, R.M.A., Holzer, C., Calabrese, J.R., Weissman, M., Reed, M., Davies, M., Frye, M.A., Keck, P., McElroy, S., Lewis, L., Tierce, J., Wagner, K.E., Hazard, E. (2003). Validity of the Mood Disorder Questionnaire: A general population study, American Journal of Psychiatry 160,178-180.

Sample:

Participants — 711 subjects (stratified by Mood Disorder Questionnaire score) were randomly selected from a group of 85,358 adult respondents in a nationwide epidemiological general population sample that was balanced for key demographic variables

Race/Ethnicity — 89% white non-Hispanic, 5% black non-Hispanic, 2.3% were Hispanic, 3.7% other ethnic backgrounds.

Summary:

This study tested the validity in the adult general population of the Mood Disorder Questionnaire, a screening instrument for bipolar I and II disorders. A sensitivity of 0.281 and a specificity of 0.972 were obtained for the Mood Disorder Questionnaire.

Hirschfeld, R.M.A., Calabrese, J.R., Weissman, M.M., Reed, M., Davies, M.A., Frye, M.A., Keck, Jr., P.E., Lewis, L., McElroy, S.L., McNulty, J.P., Wagner, K.D. (2003). Screening for bipolar disorder in the community, Journal of Clinical Psychiatry 64(1): 53-59.

Sample:

Participants — Not Specified

Race/Ethnicity — Not Specified

Summary:

The Mood Disorder Questionnaire (MDQ) was sent to a sample of 127,800 people selected to represent the U.S. adult population by demographic variables. The overall positive screen rate for bipolar I and II disorders, weighted to match the 2000 U.S. Census demographics, was 3.4%. When adjusted for the nonresponse bias, the rate rose to 3.7%. Only 19.8% of the individuals with positive screens for bipolar I or II disorders reported that they had previously received a diagnosis of bipolar disorder from a physician, whereas 31.2% reported receiving a diagnosis of unipolar depression. An additional 49.0% reported receiving no diagnosis of either bipolar disorder or unipolar depression. Positive screens were more frequent in young adults and low income households. The rates of migraine, allergies, asthma, and alcohol and drug abuse were substantially higher among those with positive screens.

Suresh, K. S., Roberts, R., & El-Mallakh, R. S. (2013). The sensitivity and specificity of the Mood Disorders Questionnaire varies with the intensity of mood illness. Psychiatric Quarterly, 84(3), 337-341

Sample:

Participants — 44 outpatient psychiatric patients

Race/Ethnicity — 53% Caucasian, 47% African American

Summary:

This study investigates the utility of the MDQ in an acute psychiatric in-patient setting. All patients admitted to an acute inpatient psychiatric unit completed the MDQ. Discharge diagnoses strictly followed DSM-IV criteria, were determined through clinical interviews, collateral information, and psychiatric history, and were used to calculate the sensitivity and specificity of the MDQ in this setting. 44 subjects were admitted during the study period; 42 completed the MDQ. 12 had bipolar illness. Sensitivity of MDQ was 0.58, and specificity was 0.76. Positive predictive value was 0.50 and negative predictive value was 0.82. The specificity and sensitivity of the MDQ appears to vary with the illness severity of the patients screened. Both the sensitivity and specificity of the MDQ are lower in severely ill psychiatric patients than in previous studies examining relatively stable outpatients.

Dodd, S., Williams, L. J., Jacka, F. N., Pasco, J. A., Bjerkeset, O., & Berk, M. (2009). Reliability of the Mood Disorder Questionnaire: Comparison with the Structured Clinical Interview for the DSM-IV-TR in a population sample. Australian And New Zealand Journal Of Psychiatry, 43(6), 526-530.

Sample:

Participants — 1066 Women

Race/Ethnicity — Not Specified

Summary:

The aim of the present study was to investigate the reliability of The Mood Disorder Questionnaire (MDQ). Screening results using the MDQ were compared with results obtained using the Structured Clinical Interview for DSM-IV-TR Research Version, Non-patient edition (SCID) in a community-based sample of 1066 women. Trained personnel, who were blind to the results of the MDQ screen, conducted clinical interviews. Results indicate using the MDQ, 21 women screened positive for bipolar disorder, and using the SCID diagnoses, 24 women were confirmed with a diagnosis of bipolar disorder. Six women were detected on both instruments. Compared to the SCID, the sensitivity for the MDQ was 25%, specificity 99%, positive predictive value 28%, negative predictive value 98%, and a demonstrated kappa of 0.25. The MDQ failed to detect any of the 11 participants in the study with bipolar II disorder and missed seven of 13 participants with bipolar I disorder or bipolar not otherwise specified. Of the 21 women who screened positive using the MDQ, 19 had current or past psychopathologies other than bipolar disorder.

Frey, B. N., Simpson, W., Wright, L., & Steiner, M. (2012). Sensitivity and specificity of the Mood Disorder Questionnaire as a screening tool for bipolar disorder during pregnancy and the postpartum period. Journal Of Clinical Psychiatry, 73(11), 1456-1461

Sample:

Participants — 150 Women

Race/Ethnicity — Not Specified

Summary:

The objective of this cross-sectional psychometric study was to investigate the use of the Mood Disorder Questionnaire (MDQ) as a screening tool for bipolar disorder in a community-based population of pregnant and postpartum women. Women who had been referred to a women’s mental health program for psychiatric assessment during pregnancy or the postpartum period were enrolled. All women completed the MDQ on the day of their first assessment, and the sensitivity and specificity of the MDQ were calculated against DSM-IV–based clinical diagnoses provided by experienced psychiatrists. Results indicate that 12% of the sample. The traditional scoring of the MDQ yielded poor sensitivity (39%) and excellent specificity (91%). The best-fitting model was a modified scoring algorithm using cutoff scores of 7 or more symptoms on the MDQ without the supplementary questions, yielding excellent sensitivity (89%) and specificity (84%).

Date Reviewed: February 2015 (Originally reviewed in February 2015)