The Validity of the Mood Disorder Questionnaire for Screening Bipolar Disorder: A Meta-Analysis

Abstract

We conducted a meta-analysis to review the diagnostic accuracy of the Mood Disorder Questionnaire (MDQ) among patients with mood disorders. We used a bivariate random effects model to calculate summary sensitivity and specificity. Twenty-one studies were included. At the standard or modified cutoff value of 7, summary sensitivity was .62 and summary specificity was .85. When we pooled 11 studies including both patients with bipolar disorder (BD) and those with unipolar depression, the summary sensitivity was .76 and summary specificity was .81. However, among the six studies that excluded patients with known BD, the summary sensitivity was significantly reduced to .37 and summary specificity was .88. There were no significant differences on the diagnostic accuracy of the MDQ between studies from Eastern and Western countries after adjusting for various clinical correlates. The overall diagnostic accuracy of the MDQ was relatively good. However, when the MDQ is applied among patients with depression without previous diagnoses of BD, its sensitivity was significantly reduced. This suggests that when the MDQ is applied among this population, its optimal cutoff value should be adjusted to enhance its sensitivity.

Improving the Screening Instrument of Bipolar Spectrum Disorders: Weighted Korean Version of the Mood Disorder Questionnaire

“…The sensitivity of the MDQ in previous meta-analyses was 0.6226) and 0.66,13) and the sensitivity and specificity of the K-MDQ was 0.75 and 0.69 in the validation study 16). The sensitivity and specificity of the K-MDQ in our study population with a cutoff value of 7 was 0.779 and 0.697.…”

“…Although it has been translated to many languages and is in global use, there still remain several concerns regarding its clinical usefulness and the appropriateness of its cutoff value 22,26). Certainly, the K-MDQ is easily administered to patients in clinical settings; it is a self-rated questionnaire in paper-and-pencil format, and the time for its completion is relatively short.…”

“…However, many studies have criticized MDQ’s usefulness and its discriminatory power for bipolar disorder 7,20–24). Additionally, some studies have suggested adjusting the cutoff value to enhance the instrument’s sensitivity 25,26)…”

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

“…Almost all individuals with cervical cancer have a positive Pap smear.) A recent meta‐analysis of studies of the MDQ found that the MDQ's sensitivity was 62% based on the recommended cutoff of 7 (Wang et al., ). Thus, more than one‐third of true cases would be missed if the MDQ was relied upon as the first stage of a two‐stage diagnostic process.…”

“…Clinicians who rely on the screening scale as the first stage of a twostage diagnostic assessment, with the second stage being the more in depth diagnostic interview, will miss the diagnosis in patients who are false negatives on the screening instrument. (Wang et al, 2015). Thus, more than one-third of true cases would be missed if the MDQ was relied upon as the first stage of a two-stage diagnostic process.…”