MDQ bipolar disorder screening test

What the MDQ measures

The Mood Disorder Questionnaire is a 13-item lifetime screen for bipolar spectrum disorders (bipolar I, bipolar II, cyclothymia). It asks about times you may have been “not your usual self” — the elevated-mood pattern that defines mania and hypomania.

About 1 in 50 adults has bipolar I or II in their lifetime. Many go years before diagnosis because the depression episodes feel like “regular depression” and the elevated periods feel like “finally feeling good.” A test that looks at the lifetime pattern catches what a single mood snapshot misses.

How the score is calculated

A positive MDQ screen requires all three of these at once:

1. Symptom count — yes on at least 7 of items 1–13.
2. Co-occurrence — yes on item 14: several of those symptoms happened during the same period.
3. Impact — moderate or serious functional problems on item 15.

Missing any one of the three keeps the screen below positive. The three-criteria design (Hirschfeld 2000) gives the MDQ roughly 70% sensitivity and 90% specificity for bipolar I in primary-care settings.

What the bands mean

• Negative screen. Below the positive-screen pattern. Not a clean bill of health, but a reasonable signal. About 30% of people with bipolar still score negative — the test errs on the side of specificity.
• Some symptoms (subthreshold). You crossed some symptom boxes but not all three criteria. This pattern fits cyclothymia, the bipolar spectrum, ADHD, anxiety, or sometimes just personality. Worth a calm conversation with primary care.
• Positive screen. All three criteria met. Not a diagnosis — but a clear signal for a proper psychiatric evaluation soon.

When the MDQ is most useful

The MDQ is not a current-mood thermometer. It asks about lifetime episodes. So it’s most useful when:

• You have had recurrent depression that doesn’t quite fit “just depression.”
• People around you have noticed periods when you were “wired,” “high,” or unusually irritable.
• Antidepressants have worked oddly — sudden energy, insomnia, racing thoughts, or worsening mood.
• A close family member has bipolar I or II (genetics matter; first-degree risk is roughly 5–10×).

Bipolar vs ADHD vs depression — overlap

Three conditions get confused for each other and the MDQ can flag any of them:

• Bipolar has discrete episodes lasting days to weeks. Sleep need drops sharply during mania.
• ADHD is a baseline pattern from childhood. Distractibility, racing thoughts, and impulsivity are constant, not episodic.
• Depression with mood reactivity can look “up” when things go well, “down” when they don’t, but without the sustained energy/sleep change.

A clinician sorts these by asking about onset, duration, sleep, and family history — questions a screening test can’t fully replicate.

Treatment is well-developed

Modern bipolar treatment keeps most people stable for years. The standard mood-stabilizing medicines (lithium, lamotrigine, valproate, certain second-generation antipsychotics) have been studied for decades. Lithium remains one of the most-cited drugs in psychiatry for a reason: it works.

Knowing the diagnosis early is one of the best predictors of long-term outcome in bipolar disorder. People who get a name for their mood pattern in their 20s do better at 40 than people who don’t. A positive MDQ doesn’t mean hospitalization, doesn’t mean losing your job, doesn’t mean you can’t have a family. It means: a 30-minute conversation with a clinician is worth booking.

Related tests

• PHQ-9 depression screen — most useful current-mood screen if depression dominates.
• GAD-7 anxiety screen — anxiety often co-occurs with bipolar spectrum.
• ADHD ASRS-5 screen — useful when distractibility and racing thoughts are constant rather than episodic.

Privacy

All scoring runs in your browser. Your answers stay on your device. Only an anonymous event (your locale and the band you fell into) is sent to a privacy-respecting analytics service.