Positive results on the MDQ were as likely to indicate that a patient has borderline personality disorder as bipolar disorder. The clinical utility of the MDQ in routine clinical practice is uncertain.
The MDQ's performance depends upon the setting in which it is used, the threshold to identify caseness, and the subtype of bipolar disorder examined. Conceptual issues in the use of a bipolar disorder screening questionnaire are discussed, and questions are raised about the clinical value of a self-report screening scale for bipolar disorder. Based on current available evidence, routine clinical use of the MDQ cannot be recommended because of the absence of studies simultaneously examining both the potential benefits (e.g., improved detection) and costs (e.g., overdiagnosis) of screening.
Most patients presenting for the treatment of bipolar disorder have missed some time from work due to psychiatric reasons, and the persistence of employment problems is considerable. Comorbid psychiatric disorders are a potentially treatable risk factor for sustained unemployment. It is therefore of public health significance to determine if current treatments are effective in bipolar disorder patients with current panic disorder, and if not, to attempt to develop treatments that are effective.
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