MDQ: Mood Disorder Questionnaire
The MDQ (Mood Disorder Questionnaire) is a 13-item self-report questionnaire that screens for a lifetime history of manic or hypomanic symptoms in adults. A positive screen needs 7 or more symptoms, clustering in the same period, and moderate or serious impairment; sensitivity 0.73 and specificity 0.90 in psychiatric outpatients (Hirschfeld et al., 2000).
MDQ Criterion 1 Interpreter
7 or more symptoms endorsed. Check Criteria 2 and 3; if all three are met, the screen is positive and a structured diagnostic interview is indicated.
Count the Yes answers on the 13 symptom items. Criterion 1 alone is not a positive screen: a positive MDQ also requires several symptoms in the same period (Criterion 2) and moderate or serious problems (Criterion 3).
| Symptoms endorsed (Criterion 1) | Interpretation |
|---|---|
| 7+ | Criterion 1 met7 or more symptoms endorsed. Check Criteria 2 and 3; if all three are met, the screen is positive and a structured diagnostic interview is indicated. |
| 0–6 | Criterion 1 not metFewer than 7 symptoms endorsed; negative screen. A negative screen does not rule out bipolar II or cyclothymia. |
Hirschfeld RM et al., Am J Psychiatry. 2000;157(11):1873-1875. A score of 7 or more items yielded sensitivity 0.73 and specificity 0.90. Educational reference only — not a diagnostic tool.
For reference only — not an assessment, diagnosis, or medical advice. This page provides scoring reference material; interpretation and clinical decisions rest with a qualified clinician.
Foundational Context
The Mood Disorder Questionnaire was developed by Robert Hirschfeld and colleagues (2000) to address the persistent underdiagnosis and misdiagnosis of bipolar disorder in clinical settings. Prior to the MDQ, no brief validated self-report questionnaire existed specifically for bipolar spectrum screening. Studies at the time documented that many patients with bipolar disorder were initially misdiagnosed with unipolar depression and received inadequate or potentially harmful treatment as a result.
The MDQ maps directly onto DSM criteria for a manic or hypomanic episode and applies a three-criterion algorithm designed to balance sensitivity and specificity. Its development involved systematic extraction of bipolar-associated symptoms from the Structured Clinical Interview for DSM (SCID), translated into accessible lay language for self-completion. The MDQ can typically be completed in 5 minutes and is appropriate for use in primary care, outpatient psychiatry, and research contexts.
What the MDQ measures
The MDQ assesses manic and hypomanic symptom history across three criteria:
Criterion 1, Symptom checklist (13 items): Respondents indicate whether they have ever experienced each of the following during the same period of time:
- Feeling so good or hyper that others thought you were not your normal self, or were so hyper you got into trouble
- Being so irritable that you shouted at people or started fights
- Feeling much more self-confident than usual
- Getting much less sleep than usual but still feeling full of energy
- Being much more talkative or speaking faster than usual
- Thoughts racing through your head, unable to slow down
- Being easily distracted by things around you, trouble concentrating
- Having much more energy than usual
- Being much more active or doing many more things than usual
- Being much more social or outgoing than usual
- Being much more interested in sex than usual
- Doing things that are unusual or risky
- Spending money in ways that got you into trouble
Criterion 2, Symptom clustering: Whether several endorsed symptoms occurred during the same time period.
Criterion 3, Functional impact: Whether the symptoms caused moderate or serious problems.
How to administer the MDQ
- Self-administered; requires approximately 5 minutes
- Available in multiple languages; widely used internationally
- Appropriate for adults; adolescent validation is less robust, use validated pediatric measures (e.g., Y-MRS, PGBI) for youth
- Should be followed by structured diagnostic assessment when screen is positive
- Most useful in populations where bipolar disorder has a meaningful base rate (e.g., patients presenting with treatment-resistant depression, recurrent mood episodes, or family history of bipolar disorder)
- Check the copyright holder's terms before clinical or commercial use of the MDQ
Documenting MDQ results in clinical notes: MDQ screen status (positive/negative) and criterion breakdown belong in the Objective section of your clinical note. See our SOAP notes guide for templates and examples.
MDQ scoring and interpretation
What is a positive screen on the MDQ?
A positive MDQ screen requires all three criteria to be met at once: 7 or more of the 13 symptoms endorsed, those symptoms clustered in the same time period, and moderate or serious functional impairment. Meeting only one or two criteria is a negative screen.
| Criterion | Requirement |
|---|---|
| 1. Symptom count | 7 or more of 13 symptoms endorsed |
| 2. Clustering | Multiple symptoms co-occurred in the same period |
| 3. Functional impact | Moderate or serious problems (not "no problem" or "minor problem") |
Interpretation Notes:
- Sensitivity for bipolar spectrum disorder: approximately 73%; specificity: approximately 90% (Hirschfeld et al., 2000; 198 mood-disorder outpatients, SCID-IV reference).
- The MDQ shows lower sensitivity for bipolar II disorder (~58%), a positive screen increases likelihood of a bipolar spectrum condition, but a negative screen does not rule out bipolar II or cyclothymia.
- A positive MDQ indicates the need for a structured clinical interview, not a diagnosis.
- Comorbid conditions (e.g., ADHD, borderline personality disorder, substance use) can produce false-positive screens; clinical context is essential.
- Some researchers use a more relaxed Criterion 3 threshold (any problem vs. moderate/serious) to improve sensitivity.
Psychometric properties
Reliability
- Good internal consistency for the 13-item checklist (α ≈ 0.90)
- Adequate test-retest reliability in outpatient samples
Validity
- Sensitivity 73%, specificity 90% for bipolar spectrum disorder in psychiatric outpatient settings (score of 7 or more items)
- Well-validated in primary care, specialty mental health, and community samples
- Positive predictive value varies by setting and base rate of bipolar disorder in the sample
- Consistently distinguishes bipolar spectrum disorders from unipolar depression in screening contexts
Limitations
- Substantially lower sensitivity for bipolar II disorder and cyclothymia than for bipolar I
- Does not assess current severity or phase of illness, only lifetime manic/hypomanic symptom history
- False positives can arise from ADHD, borderline personality disorder, substance intoxication, or anxiety disorders
- Not designed for monitoring treatment response or tracking symptom change over time
- A negative screen should not be used to exclude bipolar disorder in clinically suspicious presentations
This library is an academic and clinical reference. A scale described here is not necessarily offered in HiBoop; each page says whether it is.
Frequently Asked Questions
What is the MDQ?
The MDQ (Mood Disorder Questionnaire) is a 13-item self-report bipolar spectrum screener applying a three-criterion algorithm to flag probable bipolar I or II. It assesses lifetime history of manic and hypomanic symptoms aligned with DSM criteria. Developed by Hirschfeld et al. (2000) for use in primary care and outpatient psychiatry.
How do you score the MDQ?
The MDQ uses a three-criterion algorithm. Criterion 1 requires 7 or more of 13 lifetime manic/hypomanic symptoms answered Yes. Criterion 2 requires that several endorsed symptoms occurred during the same period of time. Criterion 3 requires moderate or serious functional impairment. A positive screen requires all three criteria to be met simultaneously.
What is a positive MDQ score?
A positive MDQ screen requires all three criteria to be met: at least 7 of 13 symptoms endorsed, symptom co-occurrence in the same period, and moderate or serious functional impairment. A positive screen indicates likely bipolar spectrum disorder and requires a structured diagnostic interview for full clinical evaluation.
Is the MDQ free?
Check the copyright holder's terms before clinical or commercial use.
Can I bill CPT 96127 for the MDQ?
Yes, CPT 96127 (brief emotional/behavioural assessment) can be billed when a clinician administers, scores, and documents the MDQ with clinical interpretation. The MDQ takes about 5 minutes and meets the time and complexity threshold for 96127. Up to four scales can be billed per visit. Documentation must include screen status (positive/negative) and clinical action.
What ICD-10 code does the MDQ support?
The MDQ supports screening for ICD-10-CM code F31.x (Bipolar disorder), including F31.1 (Bipolar disorder, current episode manic without psychotic features), F31.2 (with psychotic features), F31.81 (Bipolar II disorder), and F31.9 (Bipolar disorder, unspecified). A positive screen requires structured clinical interview to assign the specific code.
How accurate is the MDQ?
The MDQ has approximately 73% sensitivity and 90% specificity for bipolar spectrum disorder in psychiatric outpatient settings (Hirschfeld et al., 2000). Sensitivity for bipolar II disorder is lower (approximately 58%), so a negative screen does not rule out bipolar II or cyclothymia. False positives can arise from ADHD, borderline personality disorder, and substance use, so clinical context is essential.
Bill this assessment
In the US, the MDQ: Mood Disorder Questionnaire is usually billed under these CPT codes. Payer rules vary.
Using this assessment in practice
For clinicians
Send it as a gentle check-in before the session. The score is waiting when you open the chart, and the trend builds itself.
For individuals
This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
References
- 1.Hirschfeld RM, Williams JB, Spitzer RL, Calabrese JR, Flynn L, Keck PE, Lewis L, McElroy SL, Post RM, Rapport DJ, Russell JM, Sachs GS, Zajecka J. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157(11):1873-1875.View source
Last reviewed: Jun 2, 2026
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