The Mood Disorder Questionnaire (MDQ) is a brief, self-report screening instrument designed to identify symptoms of Bipolar Spectrum Disorder, specifically Bipolar I. It is primarily used in mental health and primary care settings to distinguish between unipolar depression and bipolar disorder, ensuring that clients receive the most appropriate and safe treatment plan.

• The Goal: To flag manic or hypomanic symptoms that may otherwise be overlooked during a standard depression intake.
• The Process: It consists of 13 “Yes/No” questions regarding lifetime history of elevated mood and behavioral changes.

The MDQ screens for a history of manic or hypomanic episodes by assessing 13 specific symptoms, including racing thoughts, decreased need for sleep, and increased risk-taking behaviors. It is specifically designed to identify “Bipolar I” patterns; however, clinicians should be aware that it may be less sensitive in detecting Bipolar II or other milder bipolar spectrum presentations.

A “positive” MDQ screen requires three specific criteria to be met simultaneously; a high symptom count alone is not enough for a positive result. To screen positive for a possible bipolar spectrum disorder, a client must:

• Answer “Yes” to 7 or more of the 13 symptom items.
• Confirm that several of these symptoms occurred during the same period of time.
• Report that these symptoms caused moderate to serious problems in their daily functioning.

A positive MDQ result is a clinical “red flag” that suggests a high probability of Bipolar Spectrum Disorder and necessitates a full diagnostic evaluation. It is not a diagnosis but a signal that the clinician should carefully review the client’s longitudinal history—especially if they are considering prescribing antidepressants, which can sometimes trigger manic episodes in individuals with underlying bipolar disorder.

No, the MDQ is a screening tool, not a diagnostic instrument. A formal diagnosis of Bipolar I or II requires a comprehensive clinical interview, a review of family history, and a differential assessment to rule out other conditions. The MDQ acts as the “first alert” that a more in-depth investigation is required.

The PHQ-9 measures the severity of depressive symptoms, while the MDQ screens for a history of manic or hypomanic symptoms. * When to use both: It is best clinical practice to administer both the MDQ and PHQ-9 to any client presenting with depression. This ensures that the clinician doesn’t accidentally treat a “bipolar depression” as a “unipolar depression,” which requires a significantly different therapeutic approach.

The MDQ is highly specific (approximately 90%) in specialized mood-disorder clinics, meaning it is excellent at correctly identifying people who do not have bipolar disorder. However, its sensitivity can vary (averaging around 60–70% in outpatient settings), which is why a negative MDQ screen should still be followed by careful clinical observation if symptoms persist or change.

Digital MDQ tracking via MyOutcomes ensures that the strict three-part scoring rule is applied automatically, reducing the risk of manual scoring errors. By integrating the MDQ into a digital Assessments Hub, clinicians receive immediate “Bipolar Risk Alerts” on their dashboard, allowing them to adjust treatment strategies and safety protocols before a manic or hypomanic episode escalates.