Evaluation of Mood Disorder Questionnaire (MDQ) in Patients with Mood Disorders: A Multicenter Trial across China

Abstract

BackgroundThe aim of this study was to test the ability of the Chinese version of the Mood Disorder Questionnaire (MDQ) to identify Bipolar Disorders (BD) in patients diagnosed with Major Depressive Disorder (MDD) or Unipolar Disorder (UD) in the clinical setting.Methods1,487 being treated for MDD or UD at 12 mental health centers across China, completed the MDQ and subsequently examined by the Mini International Neuropsychiatric Interview (MINI). Receiver Operating Characteristic(ROC) curves were used to determine the ability of the MDQ to differentiate between BD (BD, BD-I and BD-II) and MDD or UD and patients with BD-I from patients with BD-II.ResultsOf the 1,487 patients, 309 (20.8%) satisfied the DSM-IV criteria for BD: 118 (7.9%) for BD-I and 191 (12.8%) for BD-II. When only part one of the MDQ was used, the best cutoff was 7 between BD and UD (sensitivity 0.66, specificity 0.88, positive predictive value 0.59, negative predictive value 0.91), 6 between BD-II and UD, and 10 between BD-I and BD-II. If all three parts of the MDQ were used, the MDQ could not distinguish between BD and UD at a cutoff of 7 (or 6), and the sensitivity was only 0.22 (or 0.24).ConclusionThe Chinese version of the MDQ had good psychometric features in screening bipolar disorders from depressive patients with mood disorders when part two and part three of the MDQ were ignored.

The Influence of Current Mood States on Screening Accuracy of the Mood Disorder Questionnaire

“…These findings confirmed more disease-related burden of patients with bipolar disorder. Consistent with previous findings, our study showed that patients with bipolar disorder had higher MDQ total scores compared with patients with MDD [7,31,32]. Interestingly, the bipolar manic/hypomanic group showed similar total MDQ scores compared with bipolar depressed or euthymic groups.…”

“…Hirschfeld et al [4] suggested a standard cutoff of 7 (i.e., 7 or more symptoms detected in the first part, and those symptoms occurred simulata-neously in the second part, and the consequences of those symptoms caused moderate or serious impairment in the third part) as the optimal cutoff value. The screening accuracy of the MDQ among clinical samples has been confirmed in many previous validation studies and metaanalyses [3,[5][6][7][8][9][10][11][12][13][14][15]. In our previous meta-analysis [5], several clinical correlates were shown to impact the screening accuracy of the MDQ.…”

“…We do not exactly know why our study sample showed significantly lower specificity, however, our research included all patients with bipolar disorder who were hypomanic/manic, depressed or euthymic. The majority of previous studies included in our meta-analysis [5] calculated sensitivity and specificity among patients who were currently in a depressed state [7,10,13,[25][26][27]. This difference in population characteristics in our study sample could contribute to lower specificity of MDQ compared with previous studies included in our meta-analysis [5].…”

Early Onset Depression Has Different Characteristics from Middle-Aged Depression in Terms of Circadian Rhythm

“…The MDQ score was also higher in the eMDD group than in the lMDD group. The best cut-off MDQ score was 6 or 7, distinguishing between bipolar disorder and MDD [34]. This also implies the heterogeneous nature of the eMDD group composed of pure unipolar depression and bipolar disorder.…”

Screening for bipolar disorder with self-administered questionnaires: A critique of the concept and a call to stop publishing studies of their performance in psychiatric samples

“…This fundamental conceptual error in determining a cutoff score on bipolar disorder screening scales on the basis of optimal agreement with a diagnostic standard has continued in more recent studies. I reviewed 27 recently published studies that examined the performance of bipolar disorder screening scales across a range of scores (Bech, Christensen, Vinberg, Bech-Andersen, & Kessing, 2011;Boschloo et al, 2013;Chou et al, 2012;Cyprien et al, 2014;de Sousa Gurgel et al, 2012;Feng et al, 2016;Frey, Simpson, Wright, & Steiner, 2012;Gamma et al, 2013;Gan et al, 2012;Hsieh et al, 2016;Hu et al, 2012;Imamura et al, 2015;Kung et al, 2015;Leao & Del Porto, 2012;Lee et al, 2013Lee et al, , 2016Mosolov et al, 2014;Nallet et al, 2013;Pan & Yeh, 2015;Perugi et al, 2012;Poon, Chung, Tso, Chang, & Tang, 2012;Sasdelli et al, 2013;Smith et al, 2011;Waleeprakhon et al, 2014;Yang et al, 2014;Yang et al, 2011;Zaratiegui et al, 2011). Almost every study recommended a cutoff point on the screening scale that maximized or optimized the level of agreement with the diagnostic gold standard.…”