Mood Disorder Questionnaire (MDQ)
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The Mood Disorder Questionnaire (MDQ) is a brief screening tool used to identify signs of bipolar spectrum disorders, including Bipolar I, Bipolar II, and Cyclothymia. It focuses on lifetime history of manic or hypomanic symptoms, offering an efficient way to differentiate bipolar presentations from unipolar depression.
Developed by Dr. Robert M.A. Hirschfeld and colleagues, the MDQ is validated for use in adults 18+ and is commonly used in primary care, psychiatric, and outpatient mental health settings to trigger further assessment.
Recommended Frequency: Once during diagnostic screening; repeat as clinically indicated (e.g., during mood episodes or treatment reassessment)
About the MDQ
The MDQ is designed to capture manic or hypomanic episodes that may not be reported or recognized during standard depression assessments. It includes three sections:
- A checklist of 13 yes/no items reflecting manic symptoms (e.g., elevated mood, increased activity, irritability)
- A follow-up question about whether these symptoms occurred during the same period
- A question on functional impact, ranging from “no problems” to “serious problems”
The tool is not diagnostic, but it flags patterns that warrant deeper clinical investigation.
Who is the MDQ For?
The MDQ is suitable for adults 18 years and older, particularly those:
- Presenting with symptoms of depression, where bipolar disorder might be misdiagnosed as unipolar MDD
- Who report mood swings, impulsivity, or periods of high energy that disrupt daily functioning
- With a family history of bipolar disorder, or inconsistent response to antidepressants
Use this checklist to determine appropriateness:
- Is the client experiencing cyclical or extreme mood changes?
- Are there episodes of high energy, reduced sleep, or increased risk-taking?
- Has depression treatment been ineffective or worsened symptoms?
Note: The MDQ may have lower sensitivity for Bipolar II and women, especially those with rapid cycling or mixed episodes. Always follow up on responses with a clinical interview.
The Scale
Section 1: 13 yes/no questions assessing lifetime symptoms (e.g., “Have there been periods where you were much more active than usual?”)
Section 2: “Have several of these ever happened during the same time period?” (Yes/No)
Section 3: “How much of a problem did these cause (e.g., job, relationships)?” (None / Minor / Moderate / Serious)
Scoring the MDQ
A positive screen typically requires:
- Yes to ≥7 out of 13 symptoms in Section 1
- Yes to symptom co-occurrence in Section 2
- Moderate or Serious problems in Section 3
Screen Result
Meets all 3 criteria: Positive screen – Possible bipolar disorder
Partial criteria: Sub-threshold – Monitor and explore further
Low symptom count: Unlikely to indicate bipolar disorder
HiBoop automatically evaluates the MDQ pattern and flags positive results, prompting clinicians to explore timing, intensity, and functional impact of past episodes. It also encourages differentiation from trauma, substance use, or personality traits that may mimic bipolarity.
TIP FOR PRACTICE
Bipolar symptoms are often misdiagnosed as unipolar depression or misattributed to external stressors. Use MDQ results to guide a mood history timeline, identifying patterns of elevated energy, impulsivity, or insomnia distinct from typical emotional fluctuation.
The MDQ in Practice
Common uses of the MDQ:
- During intake for clients with mood instability
- To support differential diagnosis when standard depression treatments fail
- Alongside tools like PHQ-9, GAD-7, or trauma measures to build a more complete clinical picture
- As a risk management flag in clients with sudden mood shifts, agitation, or impulsivity
HiBoop logs MDQ results in the patient’s chart, triggers follow-up prompts, and allows clinicians to compare against baseline mood or medication changes.
Copyright
Developed by Dr. Robert M.A. Hirschfeld and the Depression and Bipolar Support Alliance (DBSA). The MDQ is free for clinical use and may be reproduced with attribution.
References
- Hirschfeld, R. M. A., et al. (2000). Screening for bipolar disorder in the community. Journal of Clinical Psychiatry, 61(1), 11–18.
- Zimmerman, M., Galione, J. N., et al. (2011). Performance of the MDQ as a screening tool for bipolar disorder in psychiatric outpatients. Bipolar Disorders, 13(4), 387–393.
Disclaimer
The MDQ is a screening tool. It is not sufficient for diagnosis and should not be used as a standalone indicator of bipolar disorder. Use in conjunction with clinical interviews, DSM-5 criteria, and full psychiatric evaluation when indicated.
Permissions
The MDQ is free for clinical use and may be reproduced with attribution.
Frequently Asked Questions
Can the MDQ diagnose bipolar disorder?
No. It flags symptoms for further evaluation but cannot confirm a diagnosis alone.
Is it accurate for Bipolar II?
The MDQ may be less sensitive for Bipolar II. Clinicians should ask about irritability, mixed states, and subthreshold hypomania even if criteria aren’t met.
Can it be used with teens or older adults?
It was designed for adults. For youth, consider age-appropriate screeners (e.g., YMRS for mania symptoms).
What if my client has high symptoms but says they weren’t a problem?
Functional impairment is important for diagnosis, but symptom presence alone should still be explored—especially if masking, normalization, or stigma are involved.
How long does it take to complete?
About 3–5 minutes.
Can clients complete the MDQ remotely?
Yes. HiBoop’s secure links allow pre-session completion and automatic flagging on the clinician dashboard.