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).
For professional reference, research, and education only. Not for diagnosis or medical advice.
MDQ Criterion 1 Interpreter
Enter a total score to see its range.
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.
The MDQ (Mood Disorder Questionnaire) is a 13-item self-report screen for a lifetime history of manic or hypomanic symptoms. A positive screen needs 7 or more symptoms, clustering in the same period, and moderate or serious problems, and calls for a structured diagnostic interview [1].
Why was the MDQ developed?
The Mood Disorder Questionnaire was developed by Robert Hirschfeld and colleagues because bipolar spectrum disorders (bipolar I, bipolar II and bipolar disorder not otherwise specified) frequently go unrecognized, undiagnosed and untreated [1]. A missed bipolar disorder is often treated as unipolar depression.
The MDQ maps onto DSM criteria for a manic or hypomanic episode and applies a three-criterion algorithm. It was validated against the bipolar module of the Structured Clinical Interview for DSM-IV (SCID) [1]. It takes about 5 minutes to complete.
What does the MDQ measure?
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:
- 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 do you give the MDQ?
- Self-administered; takes about 5 minutes
- Available in multiple languages; widely used internationally
- Validated in adults; for youth, use measures built for them (e.g., Y-MRS, PGBI)
- Should be followed by structured diagnostic assessment when the screen is positive
- Most useful where bipolar disorder has a meaningful base rate (e.g., clients with treatment-resistant depression, recurrent mood episodes, or a 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 the criterion breakdown belong in the Objective section of a SOAP note.
How do you score and interpret the MDQ?
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:
- In the original study (198 adults attending mood-disorder outpatient clinics, SCID-IV reference), sensitivity for bipolar spectrum disorder was 73% and specificity 90% [1].
- The MDQ is weaker for bipolar II disorder: in a meta-analysis the HCL-32 was more accurate than the MDQ for detecting it in mental health services [2]. 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
- Original validation. In 198 adults attending five outpatient clinics that mainly treat mood disorders, a score of 7 or more items gave sensitivity 73% and specificity 90% against a SCID telephone interview [1].
- Meta-analysis. Across 53 accuracy studies (21,542 participants), the MDQ at recommended cutoffs had summary sensitivity 66% and specificity 79% in psychiatric services [2].
- Primary care. At a cutoff of 7 in primary care or general population settings, summary sensitivity was 43% and specificity 95% [2].
- Predictive value. Positive predictive value varies by setting and by the base rate of bipolar disorder in the sample.
Limitations
- Lower accuracy for bipolar II disorder than other screens, and low sensitivity outside psychiatric services [2]
- 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
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.
Related
Billing
In the US, the MDQ: Mood Disorder Questionnaire is usually billed under these CPT codes. Payer rules vary.
Assessments
- Bipolar Test (MDQ)
- Young Mania Rating Scale (YMRS): Scoring and Cutoffs
- BPRS Scoring & Interpretation · Brief Psychiatric Rating Scale
- Schizophrenia Test (Symptoms & Assessment Guide)
- ACE Score
- Beck Anxiety Inventory (BAI) Scoring & Interpretation
Dot size shows how strongly each scale's condition is linked to this one in HiBoop's co-occurrence map.
Common paths
- Cognitive Behavioural Therapy
Added to medication, CBT was linked to more stable depressive symptoms than usual care in a network meta-analysis of 39 RCTs (3,863 participants).
Miklowitz DJ, et al. JAMA Psychiatry. 2021;78(2):141–50.
FAQ
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?
The MDQ items and its three-criterion scoring were published by Hirschfeld et al. in the American Journal of Psychiatry (2000). Publication is not a licence: check the copyright holder's terms before clinical or commercial use.
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.
- 2.Carvalho AF, Takwoingi Y, Sales PM, et al. Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies. J Affect Disord. 2015;172:337-46.
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