MDQ: Mood Disorder Questionnaire

What this assessment is

The Mood Disorder Questionnaire, or MDQ, is a brief self-report screen for a lifetime history of symptoms associated with bipolar spectrum disorders.

Robert Hirschfeld and colleagues introduced the instrument in a 2000 validation study.

Hirschfeld later described its intended primary care use in a clinical overview.

The MDQ does not produce a diagnosis. It identifies a response pattern that may justify a fuller clinical assessment.

It is not a mood severity scale.

Who it was designed for

The original validation involved adults receiving outpatient psychiatric care. A later study tested the instrument in the general U.S. population.

The MDQ is often used when bipolar disorder is a clinical possibility, including when a person reports depression that has not responded as expected.

It is not designed to decide the diagnosis alone. Use with adolescents, pregnant people, older adults, or a translated form needs evidence for that population and version.

How it is administered

The standard MDQ is self-completed and asks about experiences across the person's lifetime.

It has three parts:

• 13 yes-or-no symptom responses
• one question about whether several endorsed experiences happened during the same period
• one rating of how much difficulty those experiences caused

That gives 15 response groups, but it does not create a 15-point total.

Use the complete form. Removing the concurrence or impairment question changes the screening rule.

What it measures

The symptom section covers periods of unusually elevated or irritable mood, increased energy or activity, reduced need for sleep, faster thoughts or speech, greater confidence, distractibility, sociability, sexual interest, and risky behavior.

The concurrence question checks whether several experiences clustered in one period. The impairment question checks whether the cluster caused meaningful problems.

That structure helps separate isolated traits or events from a possible mood episode. It cannot reconstruct the episode's duration, cause, or clinical context.

How scoring works

The original positive-screen rule requires all three conditions:

• seven or more of the 13 symptom responses are endorsed
• several endorsed experiences occurred during the same period
• the reported problems were moderate or serious

If one condition is absent, the original algorithm is not positive.

Do not add all 15 response groups. Do not treat seven symptoms alone as a positive result. The concurrence and impairment responses are part of the rule.

Complete responses are needed to apply the full algorithm. A missing answer should not be assumed negative.

How to interpret an MDQ result

The result is usually reported as positive or negative under a stated algorithm.

A positive screen means the response pattern resembles patterns seen in some people with bipolar disorder. It supports a clinical interview that reviews distinct mood episodes, duration, change from usual behavior, impairment, depression history, medication effects, substance use, sleep, medical causes, and family history.

It does not prove bipolar I disorder, bipolar II disorder, or another bipolar spectrum condition.

A negative result does not rule them out. Screening sensitivity changes across settings and forms of bipolar illness.

What the result cannot tell you

The MDQ cannot determine whether endorsed experiences happened during a manic or hypomanic episode.

Similar experiences can occur with attention problems, trauma, anxiety, substance use, medication effects, sleep loss, personality traits, physical illness, or ordinary periods of high activity.

The MDQ also cannot rate current symptom severity, choose treatment, or determine urgency by itself.

Evidence and limitations

In the original psychiatric outpatient validation, the standard rule identified about 7 in 10 participants with a bipolar spectrum disorder and correctly screened out about 9 in 10 without one.

Performance changed in the general-population validation. The standard rule identified fewer than 3 in 10 people with bipolar disorder in that sample, although false positives remained uncommon.

Those results show why setting matters. A negative screen cannot close the question when the history still suggests distinct periods of elevated or irritable mood and clear change in function.