Mood Disorder Questionnaire

1. Origin and History

The Mood Disorder Questionnaire (MDQ) was developed in 2000 by the team of American psychiatrist Robert M.A. Hirschfeld, and is a standardized self-report screening tool for bipolar spectrum disorders, published in the American Journal of Psychiatry. The scale is designed based on the DSM-IV diagnostic criteria for manic/hypomanic symptoms of bipolar disorder, and its core consists of 13 manic/hypomanic symptom items plus 2 supplementary items, and thanks to its concise and efficient nature, it has become one of the most widely used bipolar disorder screening tools in global clinical and research settings.

The Chinese version of the MDQ refers to the authorized translation by Yang Haichen and others at Shenzhen Kangning Hospital in 2010, clinically validated to fit the symptom expression characteristics of the Chinese population, and is now widely used in domestic psychiatric outpatient clinics, community mental health screening, and research settings.

2. Purpose of the Test

The main purposes of the 15-item Mood Disorder Questionnaire (MDQ) include:

• Preliminary screening of whether an individual has a tendency toward the core symptoms of bipolar spectrum disorders (bipolar I, bipolar II, and cyclothymic disorder)
• Identifying the typical manifestations of manic/hypomanic episodes and distinguishing unipolar depression from bipolar disorder
• Assessing the degree to which symptoms affect work, family, social, and other areas of social functioning
• Providing psychiatrists with a rapid symptom screening reference to assist the clinical diagnostic process
• Helping individuals become aware of their mood fluctuation patterns and promptly identify signals that require professional intervention

3. Target Population

This scale is suitable for:

• Adolescents and adults aged 16 and above
• Self-assessment by people with pronounced mood swings (alternating elevated/depressed states)
• Preliminary screening of depressive/manic symptoms in psychiatric outpatient settings
• Community mental health education and screening of high-risk groups for bipolar disorder
• A reference for differentiating mood disorder types in psychological counseling

Note: this scale requires the respondent to have basic reading and self-awareness ability, and is not suitable for patients with severe cognitive impairment, acute manic episodes, or mental confusion; at the same time, its results are for screening reference only and cannot replace a psychiatrist's professional diagnosis.

4. Scale Structure and Scoring

The 15-item MDQ contains two core parts, with 15 items in total:

• Core symptom items (items 1-13): covering 13 typical symptoms of manic/hypomanic episodes, including elevated mood, irritability, overconfidence, reduced need for sleep, increased talkativeness, racing thoughts, distractibility, increased energy, increased activity, increased sociability, increased libido, impulsive behavior, and overspending
• Supplementary items (items 14-15): item 14 assesses the concurrence of symptoms (whether they occur in the same time period), and item 15 assesses the degree of distress the symptoms cause to social functioning (none/mild/moderate/severe)

Scoring is as follows: items 1-13 are scored 'no = 0, yes = 1'; item 14 is scored 'no = 0, yes = 1'; item 15 is scored 'none = 0, mild = 1, moderate = 2, severe = 3'; the criteria for a positive screen are: 7 or more 'yes' answers on items 1-13, item 14 answered 'yes,' and item 15 answered 'moderate/severe,' indicating a high risk of a bipolar spectrum disorder.

5. Limitations

Despite its wide use, the 15-item MDQ still has certain limitations:

• Self-report bias: Results depend on the respondent's subjective judgment of their own symptoms; hypomanic symptoms are easily mistaken for 'normal elevated mood,' leading to missed screening
• Not a diagnostic tool: It is only a screening tool and cannot diagnose bipolar disorder; it needs to be combined with clinical interviews, illness course tracking, and other comprehensive judgments
• Limited symptom coverage: It focuses on manic/hypomanic symptoms, has insufficient assessment of depressive-phase symptoms, and cannot assess the severity of depression on its own
• Cultural adaptability: Some symptoms (such as 'overspending' and 'increased sociability') are interpreted differently across cultures, which may affect scoring accuracy
• Insufficient identification of hypomania: It has limited sensitivity for screening hypomanic symptoms of bipolar II disorder and is prone to missed diagnosis

6. Clinical and Practical Value

As a first-line screening tool for bipolar disorder, the 15-item MDQ can quickly identify core manic/hypomanic symptoms, effectively distinguish unipolar depression from bipolar disorder, and reduce the clinical missed-diagnosis rate of bipolar disorder. Its standardized screening logic facilitates rapid assessment, and it is not only a commonly used auxiliary tool in psychiatric outpatient clinics, but also provides the general public with a scientific way to self-assess mood fluctuations, helping to promptly identify the potential risk of bipolar disorder; it is an important auxiliary means for the early identification and intervention of bipolar disorder.