MDQ
Mood Disorder Questionnaire
Self-report screen for lifetime bipolar spectrum — used to surface possible hypomania missed in depression-focused assessments.
What it measures
Section 1: 13 yes/no items on lifetime hypomanic/manic symptoms. Section 2: whether several symptoms occurred together. Section 3: functional impairment from those episodes.
Scoring and bands
Cutoffs
All three sections must meet criteria for a positive screen. Sensitivity for bipolar I is good (~73%); sensitivity for bipolar II is weaker. Specificity around 90% in psychiatric samples.
How to talk about the score
A positive MDQ is a prompt for a careful clinical interview about lifetime hypomania, not a diagnosis. Many clients with recurrent depression who screen positive turn out to be unipolar; misclassification of medications has consequences either direction.
Limitations
- Under-detects bipolar II
- Specificity drops in non-psychiatric samples
- Doesn't distinguish irritability from euphoria
- Past-episode reporting unreliable in active depression
Best used for
- Surfacing possible bipolar history when depression is the presenting concern
- Pre-medication consultation
- Adjunct to clinical interview
FAQ
Should every depressed client get an MDQ?
Many guidelines suggest yes — bipolar is frequently missed in depression presentations, and the cost of missing it is high (antidepressant monotherapy can destabilize mood).
What if a client screens positive but has never had a clear hypomanic episode?
Investigate further with structured questions about prior 'good periods' that included reduced sleep need, racing thoughts, etc. Collateral from family is often valuable.