Bipolar Test (MDQ)
Free bipolar disorder screener based on the MDQ (Mood Disorder Questionnaire). 13 yes/no questions about manic/hypomanic symptoms. Positive screen: ≥7 symptoms + same period + moderate impairment. Sensitivity 73% for bipolar I/II. Hirschfeld et al. (2000).
This bipolar test uses the MDQ (Mood Disorder Questionnaire), the most widely validated brief bipolar screener. 13 yes/no questions about manic/hypomanic symptoms. Positive screen: ≥7 symptoms + same time period + moderate impairment. Hirschfeld et al. (2000).
About This Bipolar Test
The MDQ (Mood Disorder Questionnaire) was developed by Hirschfeld and colleagues (2000) and validated across multiple clinical populations. It is specifically designed to screen for bipolar spectrum disorder — including Bipolar I, Bipolar II, and Cyclothymia — rather than unipolar depression, making it the most diagnostically specific brief bipolar screener available.
The MDQ uses a 3-part positive screen criterion: (1) ≥7 of 13 symptoms endorsed as "yes", (2) several symptoms co-occurred during the same time period, and (3) the symptoms caused at least moderate problems. All three must be met for a positive screen. This specificity minimizes false positives from unipolar depression, anxiety, or substance use.
Bipolar spectrum disorder affects approximately 2.4% of the global population across 11 countries (Merikangas et al., 2011 WMH Survey Initiative). Diagnosis is often delayed by 8–10 years (Angst et al., 2005), during which patients are frequently misdiagnosed with unipolar depression and treated with antidepressants alone — a regimen that can precipitate manic episodes. Early, accurate detection is critical for appropriate treatment, which typically includes mood stabilizers, atypical antipsychotics, and bipolar-specific psychotherapy.
Bipolar Screener (MDQ)
Has there ever been a period of time when you were not your usual self and...
Part 1, Symptom History
Has there ever been a period when you were not your usual self and experienced the following? (Yes/No)
Part 2, Same Time Period
If you checked YES to more than one of the above, have several of these ever happened during the same period of time?
Part 3, Functional Impairment
How much of a problem did any of these cause you, like being unable to work; having family, money, or legal troubles; getting into arguments or fights?
Bipolar I vs Bipolar II vs Cyclothymia
The MDQ screens for the bipolar spectrum. Understanding the distinctions between bipolar subtypes is essential, as each carries different treatment implications.
Bipolar I is defined by the presence of at least one manic episode lasting at least seven days (or less if hospitalization is required). Depressive episodes commonly occur but are not required for diagnosis. Manic episodes involve markedly elevated or irritable mood, increased energy, decreased need for sleep, grandiosity, racing thoughts, and behaviour with serious consequences.
Bipolar II requires at least one hypomanic episode and at least one major depressive episode, with no lifetime manic episodes. Hypomania resembles mania in quality but is shorter (≥4 days), less severe, and does not cause marked functional impairment or psychosis. Because hypomania can feel productive rather than distressing, Bipolar II is especially prone to being misidentified as recurrent unipolar depression.
Cyclothymia involves at least two years of fluctuating hypomanic and depressive symptoms that do not meet full criteria for a hypomanic or major depressive episode. Symptoms are chronic and rarely absent for more than two months at a time. Cyclothymia carries a significant risk of conversion to Bipolar I or II and is not a benign or "mild" variant.
Bipolar Screening Tools Compared
Several validated self-report screeners are used in clinical and research settings. The table below summarizes the most widely studied instruments, their format, and reported performance characteristics from primary validation studies in psychiatric outpatient populations.
| Screener | Items | Format | Positive threshold | Sensitivity | Specificity | Key source |
|---|---|---|---|---|---|---|
| MDQ (Mood Disorder Questionnaire) | 13 + 2 | Yes/No + 3-part screen | ≥7 symptoms + same period + moderate impairment | 0.73 | 0.90 | Hirschfeld et al., 2000 |
| HCL-32 (Hypomania Checklist) | 32 | Yes/No lifetime | ≥14 affirmative responses | 0.85 | 0.51 (Angst 2005); 0.79 (Vieta 2007) | Angst et al., 2005 |
| BSDS (Bipolar Spectrum Diagnostic Scale) | ~19 sentences | Story assent + total score | ≥13 | 0.76 | 0.85 | Ghaemi et al., 2005 |
Interpreting this table: The MDQ offers the best balance of sensitivity and specificity for combined Bipolar I/II in clinical settings. The HCL-32 trades specificity for higher sensitivity, making it useful when the goal is to avoid missing hypomanic presentations — at the cost of more false positives. The BSDS uses a narrative paragraph format that some clinicians find easier to discuss with patients. None of these screeners reliably distinguishes Bipolar I from Bipolar II on score alone, and all require clinical follow-up for a definitive diagnosis.
Mood Disorder Outcome Tracking in HiBoop
MDQ, YMRS, PHQ-9, and GAD-7, integrated mood disorder outcome monitoring for bipolar disorder, cyclothymia, and unipolar depression patient panels.
Frequently Asked Questions
What score is considered a positive MDQ screen?
A positive MDQ screen requires ALL three of the following: (1) seven or more of the 13 symptom items answered 'yes', (2) several of those symptoms occurred during the same time period, and (3) the symptoms caused at least moderate problems. Meeting only the symptom-count threshold without the other two criteria does not constitute a positive screen.
Can the MDQ diagnose bipolar disorder?
No. The MDQ is a screening tool, not a diagnostic instrument. A positive screen indicates a clinician should conduct a full structured interview. In the original validation study (Hirschfeld et al., 2000), a threshold of ≥7 symptoms yielded sensitivity of 0.73 and specificity of 0.90 in a psychiatric outpatient population; performance varies in general-population and primary care settings.
What is the difference between the MDQ and the HCL-32?
The MDQ uses a 3-part positive screen and is generally more specific; it performs similarly for Bipolar I and II. The HCL-32 (Angst et al., 2005) is a 32-item checklist focused on hypomanic symptoms, with higher sensitivity (around 80%) but lower specificity (around 51%) for separating bipolar disorder from unipolar depression. Neither instrument reliably distinguishes Bipolar I from Bipolar II on score alone.
Is the MDQ validated for adolescents?
An adolescent version (MDQ-A) exists. In a study of adolescent outpatients (Wagner et al., 2006), the parent-completed version at a threshold of ≥5 symptoms showed sensitivity of 0.72 and specificity of 0.81, outperforming self-report. The MDQ-A is not equivalent to the adult instrument and requires separate clinical interpretation.
References
- 1.Hirschfeld RM, Williams JB, 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):1873–5.View source
- 2.Hirschfeld RM, Calabrese JR, Weissman MM, et al. Screening for bipolar disorder in the community. J Clin Psychiatry. 2003;64(1):53–9.View source
- 3.Angst J, Adolfsson R, Benazzi F, et al. The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients. J Affect Disord. 2005;88(2):217–33.View source
- 4.Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011;68(3):241–51.View source
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The Bipolar Test (MDQ) qualifies for reimbursement under these CPT codes (US).
Last reviewed: Jun 3, 2026
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