The Mood Disorder Questionnaire (MDQ) is a brief self-report screening tool that helps identify people who may have a bipolar spectrum disorder. Developed by Robert Hirschfeld and colleagues in 2000, it asks about a lifetime history of manic and hypomanic symptoms, whether those symptoms clustered in the same period, and how much they affected daily functioning.
Why healthcare providers use the MDQ
- Efficient screening. The MDQ takes about five minutes to complete and gives clinicians a fast read on possible bipolar spectrum symptoms.
- Catches an overlooked pattern. Bipolar disorder is often mistaken for unipolar depression, and the MDQ prompts questions about manic and hypomanic history that a depression screen alone can miss.
- Structured symptom review. The 13 symptom items map to recognized manic and hypomanic features, giving a consistent framework across patients and visits.
- Validated performance. In the original specialty clinic sample the MDQ showed a sensitivity of about 73 percent and a specificity of about 90 percent.
- Guides next steps. A positive screen prompts follow-up and a fuller diagnostic assessment rather than serving as a diagnosis on its own.
Which settings use the MDQ?
- Primary care. Clinicians use the MDQ to screen patients who present with depression or mood complaints and may have an unrecognized bipolar history.
- Psychiatric and mental health clinics. Behavioral health teams use it at intake to structure the initial history and flag cases for closer evaluation.
- Community and telehealth programs. Because it is short and self-administered, the MDQ works well for remote intake and population screening.
What does the MDQ measure?
The MDQ screens for a lifetime history of manic and hypomanic symptoms. Its first 13 items ask whether the patient has experienced specific mood, energy, and behavior changes, and two follow-up questions ask whether those symptoms occurred together and how much they interfered with life. The instrument covers these domains:
- Elevated or irritable mood and energy. Periods of feeling unusually high, hyper, or irritable with a marked increase in energy.
- Sleep, activity, and speech changes. Reduced need for sleep, increased activity or restlessness, and being more talkative than usual.
- Cognitive and behavioral shifts. Racing thoughts, distractibility, heightened confidence or sociability, and impulsive or risky behavior.
- Clustering and functional impact. Whether several symptoms occurred during the same period and how severely they affected work, family, or social life.
Scoring the MDQ
- Number of items. 13 yes or no symptom questions, plus two follow-up questions on symptom clustering and functional impairment.
- Per-item scale. Each of the 13 symptom items is answered yes or no. The impairment question uses four options: none, minor, moderate, or serious.
- Total score range. 0 to 13 on the symptom items. The two follow-up questions are scored as pass or fail criteria rather than added points.
- Score direction. More yes responses, combined with same-period clustering and at least moderate impairment, indicate a higher likelihood of a positive screen.
The MDQ is a screen, not a severity scale, so there are no graded score bands. A positive screen requires all three published criteria to be met at once: seven or more of the 13 symptoms endorsed, several symptoms occurring during the same period, and moderate or serious functional problems. The MDQ is less sensitive for bipolar II and milder presentations, and its accuracy is lower in low-prevalence settings such as general primary care, so results should guide clinical decision-making rather than confirm or rule out a diagnosis.
| Score | Interpretation | Suggested next step |
|---|---|---|
| Fewer than 7 symptoms, or clustering or impairment criteria not met | Negative screen | Continue routine monitoring; reassess if concerns arise |
| 7 or more symptoms, plus same-period clustering, plus moderate or serious problems | Positive screen | Consider further diagnostic assessment |
Best practices for administration
- Frame it as a lifetime screen. Remind patients the questions ask about any period in their life, not just how they feel today.
- Apply all three criteria. Score a screen positive only when the symptom count, clustering, and impairment questions are all met.
- Confirm with clinical interview. Always pair a positive result with a structured history, since the MDQ cannot establish a diagnosis on its own.
- Consider collateral input. Family or partner observations can help, because patients may under-recognize their own manic or hypomanic episodes.
- Interpret by setting. Weigh the higher rate of false positives in low-prevalence populations and the reduced sensitivity for bipolar II.
How Zentake helps with the MDQ
- Automatic scoring. Zentake tallies the symptom count and checks the criteria on submit, so there is no hand-tallying.
- Before the visit. Patients complete the MDQ from home on any device, so mental health practices start the appointment already informed.
- HIPAA compliant. Responses are encrypted, with a signed BAA on every plan.
References
Hirschfeld RMA, Williams JBW, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. American Journal of Psychiatry, 2000;157(11):1873-1875. This primary validation study established the 13-item structure, the three positive-screen criteria, and the reported sensitivity of about 73 percent and specificity of about 90 percent in a specialty outpatient sample.
Subsequent reviews note that MDQ sensitivity is higher for bipolar I than for bipolar II and that positive predictive value falls in lower-prevalence primary care populations, which is why the instrument is used as a screen rather than a diagnostic test.
Last updated: August 2026