Mood Disorder Questionnaire
Mood Disorder Questionnaire (MDQ) is a self-report questionnaire designed to help detect the presence of a mood disorder, particularly Bipolar Disorder. It was developed by a team of psychiatrists, researchers, and consumer advocates in 2000, with Dr. Robert M.A. Hirschfeld leading the initiative. The MDQ has become a widely used tool in both clinical and research settings to screen for bipolar disorder, which is characterized by significant fluctuations in mood, energy, and activity levels.
Development and Purpose
The Mood Disorder Questionnaire was developed in response to the need for a quick, reliable method to screen for bipolar disorder, a condition often misdiagnosed as unipolar depression. The misdiagnosis can lead to treatment plans that are ineffective or even harmful. The MDQ aims to provide a simple and efficient screening method that can be used in various settings to identify individuals who may require a more comprehensive psychiatric evaluation for bipolar disorder.
Structure
The MDQ consists of three parts:
- A 13-item symptom checklist that asks respondents to indicate whether they have experienced certain symptoms of bipolar disorder.
- A question regarding the co-occurrence of symptoms.
- A question about the level of functional impairment caused by the symptoms, if any.
Respondents are asked to answer the questions based on their lifetime experience. The symptom checklist items are derived from the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for bipolar disorder and are focused on hypomanic and manic episodes.
Scoring and Interpretation
The MDQ is scored by counting the number of symptoms endorsed in the first section, with a higher number of symptoms generally indicating a higher likelihood of bipolar disorder. The second and third parts of the questionnaire are used to provide additional context to the symptom count, particularly regarding the co-occurrence of symptoms and the impact on the individual's life.
A positive screen for bipolar disorder typically requires a certain threshold of symptoms to be met, along with the symptoms occurring together and causing significant impairment. However, the MDQ is not a diagnostic tool but a screening instrument that indicates the need for further evaluation.
Validity and Reliability
Research has shown the Mood Disorder Questionnaire to have good sensitivity (the ability to correctly identify those with the condition) and specificity (the ability to correctly identify those without the condition) for bipolar disorder, particularly for bipolar I disorder. However, its effectiveness can vary depending on the population being screened and the setting in which it is used.
Usage
The MDQ is used in a variety of settings, including primary care, psychiatric outpatient clinics, and research studies. It is available in multiple languages and is used worldwide. The questionnaire can be administered by healthcare professionals or self-administered by the individual.
Limitations
While the MDQ is a valuable tool for screening bipolar disorder, it has limitations. It may not be as effective in detecting bipolar II disorder or cyclothymia. Additionally, the self-report nature of the questionnaire means that responses can be influenced by the individual's insight into their condition and willingness to report symptoms accurately.
Conclusion
The Mood Disorder Questionnaire is an important tool in the early detection of bipolar disorder, facilitating timely and appropriate treatment. Despite its limitations, the MDQ remains a widely used and valuable screening instrument in the field of mental health.
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Contributors: Prab R. Tumpati, MD