Mood Disorder Questionnaire

The Mood Disorder Questionnaire (MDQ) is a validated 15-item self-report screening measure widely used by clinicians to systematically assess a lifetime…

Questions: 15
Duration: 5 min
Original title: Mood Disorder Questionnaire
Adaptation: Mood Disorder Questionnaire
Authors: Hirschfeld, R.M.A., Williams, J.B.W., Spitzer, R.L., Calabrese, J.R., Flynn, L., Keck, P.E., Lewis, L., McElroy, S.L., Post, R.M., Rapport, D.J., Russell, J.M., Sachs, G.S., Zajecka, J.
Created: 2000

The Mood Disorder Questionnaire (MDQ) is a validated 15-item self-report screening measure widely used by clinicians to systematically assess a lifetime history of manic and hypomanic symptoms. Originally developed by Hirschfeld and colleagues, it addresses a significant clinical challenge: the frequent misidentification of bipolar spectrum presentations as unipolar depression.

Because patients rarely seek help during hypomanic phases, their symptom history can be easily overlooked. The MDQ provides a standardized framework to capture these past periods of elevated mood, expansive behavior and decreased need for sleep. Integrating this measure into your longitudinal case formulation helps clarify the diagnostic picture and ensures that treatment planning correctly accounts for mood instability. It is especially useful for intake evaluations, allowing practitioners to thoroughly review past bipolar disorder warning signs before finalizing a diagnostic conceptualization.

Example result

Fictitious result, computed from a sample set of answers.

The MDQ is a self-report screening questionnaire for bipolar spectrum disorders (types I, II, and NOS) in adults. It assesses the lifetime presence of symptoms suggestive of a manic or hypomanic episode (elevated/irritable mood, increased energy and activity, disinhibition, decreased need for sleep, racing thoughts, impulsive behaviors), their co-occurrence during the same time period, and functional impairment. It does not provide a diagnosis but prompts a comprehensive clinical evaluation.

Bipolar disorder screening→ Negative screen

—

At least 7 out of 13 symptoms

53% of items checked "Yes" (questions 1–13)

6/13 items · requis ≥ 7

✓

Symptoms occurred during the same time period

"Yes" to question 14

item 14 : 1 · requis ≥ 1

✓

Moderate or serious impairment

Question 15 rated "Moderate" or "Serious" (≥ 2 on 0–3)

item 15 : 2 · requis ≥ 2

Screening is positive only if ALL THREE conditions are met simultaneously: the symptom count alone is not sufficient. A positive screen is not a diagnosis.

Hirschfeld et al. (2000)

Manic/hypomanic symptoms (13 items)

6/ 13

The MDQ items assess a range of content reflecting the diverse symptom criteria for hypomania and mania, including elevated mood, increased energy and activity, grandiosity, decreased need for sleep, racing thoughts, distractibility, increased goal-directed activity, and impulsive or risky behaviour.

items 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

013

Temporal co-occurrence of symptoms

1/ 1

Item asking if the symptoms clustered in the same time period.

items 14

Psychosocial impairment

2/ 3

Item asking if the symptoms caused problems and assessing psychosocial impairment.

items 15

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What the test measures

The MDQ captures a lifetime history of manic and hypomanic symptoms across three distinct clinical domains. It evaluates not just the presence of symptoms but also their temporal clustering and functional impact.

Symptom endorsement: Assesses 13 specific criteria for hypomania and mania, including elevated mood, grandiosity, reduced need for sleep, racing thoughts and impulsive risk-taking.
Symptom co-occurrence: Determines whether the endorsed features occurred concurrently during the same distinct timeframe, satisfying the syndromal requirement of an episode.
Psychosocial impairment: Measures the real-world consequences of these behaviors on the patient's occupational, legal, financial and relational stability.

This instrument is intended for adults in psychiatric or primary care settings when a mood disorder is suspected.

When and why to use it

Clinicians typically administer the MDQ to adults presenting with mood complaints, particularly when there is a risk that bipolarity might be masked by a current depressive episode.

Intake baseline screening: To systematically rule in or rule out a history of bipolar disorder before initiating antidepressant pharmacotherapy.
Diagnostic clarification: To re-evaluate patients whose depressive symptoms show atypical features, high recurrence or resistance to standard interventions.
Psychoeducational prompting: To help patients recognize past hypomanic behaviors they may have normalized, shifting the clinical focus toward building adaptive vs maladaptive coping strategies during mood elevations.
Family history follow-up: To investigate further when a patient reports a first-degree relative with a known bipolar spectrum condition.

While clinical observation can detect current affective states, a standardized MDQ score reliably flags historical symptom clusters that require deeper diagnostic interviewing.

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The questions

Please answer each question as best you can. Check 'Yes' or 'No' for each question.
1. Has there ever been a period of time when you were not your usual self and... you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble?
Assesses periods of unusually elevated or expansive mood that distinctly deviate from the patient's baseline.
- No
- Yes
2. ...you were so irritable that you shouted at people or started fights or arguments?
Evaluates episodes of uncharacteristic irritability, anger or confrontational behavior.
- No
- Yes
3. ...you felt much more self-confident than usual?
Checks for inflated self-esteem or grandiosity typical of manic states.
- No
- Yes
4. ...you got much less sleep than usual and found you didn’t really miss it?
Screens for a decreased need for sleep, a primary physiological marker of hypomania.
- No
- Yes
5. ...you were much more talkative or spoke faster than usual?
Assesses pressure of speech or uncharacteristic loquaciousness.
- No
- Yes
6. ...thoughts raced through your head or you couldn’t slow your mind down?
Explores the subjective experience of flight of ideas or racing thoughts.
- No
- Yes
7. ...you were so easily distracted by things around you that you had trouble concentrating or staying on track?
Evaluates severe distractibility and the inability to filter out extraneous environmental stimuli.
- No
- Yes
8. ...you had much more energy than usual?
Checks for sudden, uncharacteristic surges in physical or mental energy.
- No
- Yes
9. ...you were much more active or did many more things than usual?
Measures significant increases in goal-directed activity or psychomotor agitation.
- No
- Yes
10. ...you were much more social or outgoing than usual, for example, calling friends in the middle of the night?
Assesses heightened sociability, boundary diffusion or disinhibited social contact.
- No
- Yes
11. ...you were much more interested in sex than usual?
Screens for hypersexuality or a distinct, uncharacteristic increase in sexual drive.
- No
- Yes
12. ...you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky?
Evaluates engagement in impulsive, foolish or excessively risky activities without regard for consequences.
- No
- Yes
13. ...the spending you did caused trouble for you or your family?
Checks for financial recklessness and the concrete psychosocial fallout it causes.
- No
- Yes
14. If you checked 'Yes' to more than one of the above questions, did several of them happen during the same period of time?
Determines the temporal co-occurrence of the endorsed manic symptoms to confirm syndromal clustering.
- No
- Yes
15. How much of a problem did any of these cause you — such as being unable to work; having family, money or legal troubles; or getting into arguments or fights?
Assesses the degree of psychosocial, occupational or interpersonal impairment caused by these mood episodes.
- No problem
- Minor problem
- Moderate problem
- Severe problem