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Mood Disorder Questionnaire (MDQ)

Also known as: MDQ

OriginatorRobert M. Hirschfeld and colleaguesYear2000Sources2Related methods5

The Mood Disorder Questionnaire (MDQ) is a 13-item self-report screening instrument designed to identify individuals at risk for bipolar spectrum disorders. Developed by Hirschfeld and colleagues in 2000, the MDQ assesses symptoms of mania and hypomania as well as the clustering of symptoms into distinct episodes. It is widely used in primary care, psychiatric practice, and research to improve detection of bipolar disorder.

Key highlights

  • Specifically targets bipolar spectrum disorder, addressing critical gap in unipolar depression-focused screening
  • Brief yes/no format enables rapid administration in busy primary care and psychiatric settings
  • Good sensitivity and specificity for bipolar I disorder with high positive predictive value
  • Helps prevent the common error of treating bipolar depression with antidepressant monotherapy

Intuition

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How it works

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When to use it

The MDQ is ideal for screening in primary care, general mental health settings, and when bipolar disorder is in the differential diagnosis. It is particularly valuable for identifying bipolar disorder masquerading as treatment-resistant depression. The instrument is less useful in pure bipolar disorder populations (where diagnosis is already known) and less suitable for diagnosing bipolar disorder without clinical interview.

Strengths & limitations

Strengths
  • Specifically targets bipolar spectrum disorder, addressing critical gap in unipolar depression-focused screening
  • Brief yes/no format enables rapid administration in busy primary care and psychiatric settings
  • Good sensitivity and specificity for bipolar I disorder with high positive predictive value
  • Helps prevent the common error of treating bipolar depression with antidepressant monotherapy
Limitations
  • Lower sensitivity for bipolar II disorder and cyclothymia; hypomania may be under-reported by patients
  • Requires clinical interview for diagnosis; positive screen alone does not diagnose bipolar disorder
  • False positives possible in individuals with ADHD, substance intoxication, or personality disorders that mimic manic symptoms

Common pitfalls

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Applications

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Frequently asked

What does a positive MDQ screen mean?

A positive MDQ screen suggests possible bipolar spectrum disorder but is not diagnostic. Clinical interview is required to confirm bipolar disorder diagnosis, assess symptom duration, functional impairment, and rule out secondary causes (medical conditions, substance use).

Can the MDQ distinguish bipolar I from bipolar II disorder?

The MDQ screens for manic and hypomanic symptoms but does not reliably distinguish between bipolar I and bipolar II. Bipolar I involves full manic episodes; bipolar II involves hypomanic episodes. Both can screen positive on MDQ; clinical assessment of episode severity and duration is required.

Should antidepressants be started based on MDQ positive screen?

No. MDQ positive screen should prompt clinical evaluation, not immediate antidepressant initiation. Starting antidepressants without confirming bipolar disorder and establishing mood stabilizer first risks triggering manic episodes.

How sensitive is MDQ for bipolar II disorder?

MDQ sensitivity for bipolar II disorder is lower than for bipolar I (approximately 50–60% vs. 70–80%). Bipolar II patients may underreport hypomania or attribute symptoms to personality. Clinical interview probing mood patterns is crucial when bipolar II is suspected.

Sources

  1. 1.
    Hirschfeld, R. M., Williams, J. B., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E., ... & 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.
    DOI 10.1176/appi.ajp.157.11.1873
  2. 2.
    Zimmerman, M., Galione, J. N., Chelminski, I., Young, D., Dalrymple, K., & Francione, C. (2008). Performance of the Mood Disorder Questionnaire screener for bipolar disorder in psychiatric outpatients. Bipolar Disorders, 10(1), 107-114.
    https://scholar.google.com/scholar?q=Performance+of+the+Mood+Disorder+Questionnaire+screener+for+bipolar+disorder+in+psychiatric+outpatients+Zimmerman

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ScholarGate. (2026, June 3). Mood Disorder Questionnaire. ScholarGate. https://scholargate.app/clinical-psychology/mdq-mood-disorder