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Mood Disorder Questionnaire (MDQ) for Bipolar Disorder

The MDQ screens for bipolar spectrum disorder. It is positive when 7 or more of the 13 manic/hypomanic symptom items are endorsed AND several occurred during the same period AND they caused a moderate or serious problem (sensitivity 0.73, specificity 0.90 in the psychiatric outpatient validation).

  • Felt so good or so hyper that others thought you were not your normal self, or got into trouble (yes/no, +1)
  • So irritable that you shouted at people or started fights or arguments (yes/no, +1)
  • Felt much more self-confident than usual (yes/no, +1)
  • Got much less sleep than usual and found you didn't really miss it (yes/no, +1)
  • Much more talkative or spoke much faster than usual (yes/no, +1)
  • Thoughts raced through your head or you couldn't slow your mind down (yes/no, +1)
  • So easily distracted that you had trouble concentrating or staying on track (yes/no, +1)
  • Had much more energy than usual (yes/no, +1)
  • Much more active or did many more things than usual (yes/no, +1)
  • Much more social or outgoing than usual (e.g. phoned friends in the middle of the night) (yes/no, +1)
  • Much more interested in sex than usual (yes/no, +1)
  • Did things that were unusual, excessive, foolish or risky (yes/no, +1)
  • Spending money got you or your family into trouble (yes/no, +1)
  • Have several of these ever happened during the same period of time? (yes/no)
  • How much of a problem did any of these cause (work, family, money, legal, fights)?: No problem; Minor problem; Moderate problem; Serious problem
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Interpretation

ResultMeaning
≥7 symptoms + same period + moderate/serious problemPositive screen
Any criterion not metNegative screen

Formula

Positive if (number of "yes" answers to the 13 items in question 1) ≥ 7 AND question 2 (several happened during the same period) = yes AND question 3 (problem caused) = moderate or serious.

Clinical pearls

  • A screen, not a diagnosis: false positives are common with borderline personality disorder, ADHD and substance use; confirm with a structured clinical interview.
  • Sensitivity is lower for bipolar II (hypomania); some studies drop the impairment criterion to improve sensitivity, at the cost of specificity.
  • Screen for bipolarity before starting an antidepressant in a patient presenting with depression.

Examples

mdq 9 yes answers, same period, serious problemmood disorder questionnaire: racing thoughts, less sleep, talkative, more energy, more active, irritable, risky behaviour, overspending; happened together; moderate problembipolar screen 5 symptoms, minor problem

FAQ

What is a positive MDQ?

Seven or more "yes" answers to the 13 symptom questions, with several symptoms occurring during the same period and causing a moderate or serious problem.

Can the MDQ diagnose bipolar disorder?

No. It is a screening tool (sensitivity about 73%, specificity about 90% in the original study); diagnosis requires clinical assessment.

Evidence

  1. Hirschfeld RM et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry 2000;157:1873–5.

Psychiatry & Substance Use · Reviewed 2026-10-14 · Methodology