Calculators / Bipolar spectrum

MDQ

Mood Disorder Questionnaire. Self-report screen for bipolar spectrum disorder.

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The MDQ calculator is in the Library.

Every rating scale calculator comes with the Library, along with the prescribing guides, medication handouts, DSM-5 criteria and sheets, and the Guide Builder.

Use it for

  • Screening a person in a mental health or primary care setting for bipolar spectrum disorder, especially before treating depression.
  • Prompting a conversation about the highs, and finding out how much trouble they caused.
  • Deciding who needs a diagnostic interview.

Do not use it for

  • Diagnosing bipolar disorder. A positive screen starts an interview.
  • Ruling bipolar disorder out. Sensitivity was 0.73 in psychiatric outpatients and only 0.28 in a general population sample, and it is better at bipolar I than bipolar II.
  • Rating current mania or following treatment. Use a rating scale such as the YMRS.

The MDQ carries a copyright notice from the University of Texas Medical Branch, and this page does not reproduce the questionnaire. Each symptom below is a short checklist label in our own words. Ask about a time when the person was not their usual self, or enter the answers from the MDQ form they filled in.

Mark yes for every symptom that has ever happened. Answer questions 14 and 15 when there are seven or more yeses. They do not change a result below seven.

Symptoms

Has there ever been a period of time when the person was not their usual self and...

1So good or hyper that others noticed, or it caused trouble
2So irritable that they shouted or started fights
3Much more self-confident than usual
4Much less sleep than usual, without missing it
5Much more talkative or faster speech
6Racing thoughts, could not slow the mind down
7So easily distracted that they lost track
8Much more energy than usual
9Much more active or doing many more things
10Much more social or outgoing than usual
11Much more interested in sex than usual
12Did things that were unusual, excessive, foolish or risky
13Spending money got them or family into trouble

Same period and problem

Answer these when 7 or more symptoms are marked yes. The problem question matters only when the symptoms occurred together.

14Several of these symptoms happened during the same period of time
15How much of a problem these caused, such as not being able to work, or family, money or legal trouble, or arguments and fights

Context, not scored

Family history and a past diagnosis. They are not part of the screen, but they raise concern.

16A blood relative has manic-depressive illness or bipolar disorder
17A health professional has told the person they have manic-depressive illness or bipolar disorder

MDQ

Answer the questions to see the result.

This calculator adds up the score in your browser. Nothing you enter is stored or sent.

More about the MDQ

About the MDQWhat it is and what it is for

The Mood Disorder Questionnaire is a one-page screen for bipolar spectrum disorder. Hirschfeld, Williams, Spitzer and colleagues published it in 2000. The person says whether 13 manic and hypomanic symptoms have ever happened, whether several happened in the same period, and how much of a problem they caused.

A screen is positive when all three conditions are met: seven or more of the 13 symptoms, several of them in the same period, and a moderate or serious problem. It was built to find bipolar disorder in psychiatric clinics, and it works much less well in the general population.

How to use itGiving it and scoring it

Ask whether each of the 13 symptoms has ever happened during a time when the person was not their usual self, or enter the answers from the form they filled in. Count the yeses. If there are seven or more, ask whether several happened in the same period, and how much of a problem they caused. This page does the counting and applies the rule.

The family history and past diagnosis questions are context. They are not part of the screen.

Interpreting the scoreScore ranges and what they suggest
Symptoms marked yesWhat it suggestsUsual response
0 to 6Fewer than 7 symptomsBelow the symptom count the screen needs.The screen is negative. It does not rule out bipolar disorder.
7 to 137 or more symptomsEnough symptoms for a positive screen if they clustered and caused a moderate or serious problem.Check the two questions that follow. Both must be met.

A positive screen needs all three: 7 or more symptoms, several in the same period, and a moderate or serious problem. A count of 7 or more on its own is not a positive screen. Some clinicians look at the count alone as a looser screen.

Pearls and pitfallsTips and common mistakes
  • A positive screen needs all three conditions. Do not call it positive on the count alone.
  • Ask what the person was doing during a yes. The story behind the answers is the real information.
  • A negative screen in a person with depression and a family history of bipolar disorder still deserves a conversation.
  • Check each antidepressant the person has taken for activation, irritability or a rapid switch.
  • Pair it with the Modified RMS for depression and the HCL-32 for hypomanic symptoms.
EvidenceAccuracy and reliability
  • In the development study (Hirschfeld 2000), 198 psychiatric outpatients were screened against a structured interview. At seven or more symptoms with clustering and a problem rated moderate or serious, sensitivity was 0.73 and specificity 0.90.
  • In a general population sample (Hirschfeld 2003), sensitivity was 0.28 and specificity 0.97, so the MDQ picks up few cases of bipolar disorder in the community.
  • The screen is better at bipolar I than at bipolar II.
  • The authors state that it is a screening instrument, not a diagnostic tool.
Source, license and referencesWhere it comes from

The Mood Disorder Questionnaire was developed by Robert Hirschfeld, Janet Williams, Robert Spitzer and colleagues and published in the American Journal of Psychiatry in 2000. The questionnaire carries a University of Texas Medical Branch copyright notice. This page does not reproduce it. The symptom labels are written in our own words as a checklist for the interview, and the scoring rule is the published one.

  1. Hirschfeld RMA, Williams JBW, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157(11):1873-1875.
  2. Hirschfeld RMA, Holzer C, Calabrese JR, et al. Validity of the Mood Disorder Questionnaire: a general population study. Am J Psychiatry. 2003;160(1):178-180.
  3. Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20(2):97-170.

Clinical decision support, not a diagnosis. Each calculator scores a published scale the way its authors intended. A score informs a clinical interview and examination and never replaces them. If you are a patient using this page, please review the result with your clinician. In an emergency, call 911 or call or text 988 in the United States.