Sensitivity and specificity of the Mood Disorder Questionnaire for detecting bipolar disorder

Miller, Christopher J; Klugman, Jeffry; Berv, Douglas A; Rosenquist, Klara J; Nassir Ghaemi, S

doi:10.1016/S0165-0327(03)00156-3

« Previous Next »Journal of Affective Disorders
Volume 81, Issue 2 , Pages 167-171, August 2004

Sensitivity and specificity of the Mood Disorder Questionnaire for detecting bipolar disorder

Christopher J Miller
- Bipolar Disorder Research Program, Cambridge Hospital, Cambridge, MA, USA
- Consolidated Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Jeffry Klugman
- Atlantic Health Services, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Douglas A Berv
- Atlantic Health Services, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
Klara J Rosenquist
- Bipolar Disorder Research Program, Cambridge Hospital, Cambridge, MA, USA
- Consolidated Department of Psychiatry, Harvard Medical School, Boston, MA, USA
S Nassir Ghaemi
- Bipolar Disorder Research Program, Cambridge Hospital, Cambridge, MA, USA
- Consolidated Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Corresponding author. Department of Psychiatry, The Cambridge Hospital, 1493 Cambridge St., Cambridge, MA 02139, USA. Tel.: +1-617-665-1612; fax: +1-617-665-1623.

Received 23 August 2002; accepted 3 June 2003.

Abstract

Background: This study aims to replicate the sensitivity and specificity of the Mood Disorder Questionnaire (MDQ) for bipolar disorder and assess the impact of insight on the MDQ’s sensitivity. Unlike prior telephone-based validation, this is the first clinical study to assess the validity of the MDQ. Methods: 37 consecutive patients with bipolar spectrum illness received the MDQ, as well as 36 consecutive patients with unipolar depression. MDQ diagnoses were compared to DSM-IV-based SCID diagnoses. A total of 16 bipolar patients also received the Scale to Assess Unawareness of Mental Disorder (SUMD) to measure insight. Results: Overall sensitivity for the MDQ was 0.58, higher in bipolar I disorder (0.69) than in bipolar II/NOS (0.30, P=0.06). The sample was highly insightful, but the two patients with lowest insight both had false negative screens. Patients’ low ratings of severity of mania (question 3 of the MDQ) explained almost half of all false negative results. Specificity was 0.67. Conclusions: The MDQ demonstrates good sensitivity in insightful patients with bipolar I disorder, but may be less useful in patients with impaired insight or milder bipolar spectrum conditions.

Keywords: Self-report, Rating scales, Bipolar disorder, Diagnosis, Misdiagnosis, Mania