MDQ Test — Mood Disorder Questionnaire (Bipolar Spectrum Screener)
The Mood Disorder Questionnaire — the standard 13-item screener for bipolar spectrum. 3 minutes, instant screen result. Free in the Mindtalk app.
Clinically reviewed by Dr. Krishna K R, MBBS MD fellowship in Psyco Sexual Medicine. Last reviewed 2026-09-25.
Important safety information
The MDQ includes a question about thoughts of self-harm (question 9). If you have had any such thoughts recently, please reach out for support before or instead of taking this assessment — you do not need to take a test to deserve help.
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The 13 MDQ Section 1 items — lifetime symptom check
Each item asks: "Has there ever been a period of time when you were not your usual self and…" Answer Yes or No for each. The 13 items cover:
- Felt so good or hyper that other people thought you were not your usual self / got into trouble
- Were so irritable that you shouted at people or started fights
- Felt much more self-confident than usual
- Got much less sleep than usual and found you didn't really miss it
- Were much more talkative or spoke faster than usual
- Thoughts raced through your head; you couldn't slow your mind down
- Were so easily distracted that trivia caught your attention
- Had much more energy than usual
- Were much more active or did many more things than usual
- Were much more social or outgoing than usual
- Were much more interested in sex than usual
- Did things unusual for you, or that others might have thought were excessive, foolish, or risky
- Spending money got you or your family into trouble
Section 2 — co-occurrence
Did several of the Section 1 items occur during the same period of time? Answer Yes or No.
Section 3 — impairment
How much of a problem did any of these cause you? (No problem / Minor / Moderate / Serious)
Scoring — what makes a positive screen
A positive screen requires ALL three:
- Yes to 7 or more items in Section 1
- Yes in Section 2 (several symptoms co-occurred)
- Moderate or Serious in Section 3 (functional impairment)
If any of the three is negative, the screen is negative. The 3-part rule is deliberate — endorsing many symptoms without co-occurrence and impairment often reflects ADHD, personality traits, or normal variation.
How the MDQ was developed
The MDQ was developed by Robert Hirschfeld and colleagues at the University of Texas Medical Branch in 2000 (American Journal of Psychiatry, 2000). It was designed to close the diagnostic gap for bipolar disorder: bipolar spectrum disorders frequently go unrecognised and untreated, and many people are first treated for unipolar depression. For background on the condition, see our bipolar disorder guide.
The 13 Section 1 items were selected to cover DSM-IV manic and hypomanic criteria plus the associated features that distinguish bipolar from unipolar depression. The 3-part scoring rule (symptoms + co-occurrence + impairment) was added to reduce false positives from people who endorse individual symptoms in isolation.
Later studies showed the MDQ misses more people when hypomania is milder, which is why some clinicians add the HCL-32 (Hypomania Checklist) when bipolar II is suspected.
Validation and evidence
The original validation, published in the American Journal of Psychiatry in 2000, gave the MDQ to 198 patients at five mood-disorder outpatient clinics and compared it with a blind telephone Structured Clinical Interview for DSM-IV; a screen of 7 or more items yielded 73% sensitivity and 90% specificity. When the same team tested it in a US general-population sample of 695 adults in 2003, sensitivity was 28% and specificity 97%, showing that its performance depends heavily on the setting. A 2015 meta-analysis of 21 studies reported pooled sensitivity of 62% and specificity of 85% at a cut-off of 7; in studies of depressed patients without a known bipolar diagnosis, sensitivity dropped to 37% (specificity 88%), and the authors suggested adjusting the cut-off in that group. Accuracy did not differ significantly between Eastern and Western studies. We could not verify a published Indian validation.
References
- Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157(11):1873-1875. PubMed
- Hirschfeld RM, Holzer C, Calabrese JR, et al. Validity of the mood disorder questionnaire: a general population study. Am J Psychiatry. 2003;160(1):178-180. PubMed
- Wang HR, Woo YS, Ahn HS, et al. The validity of the Mood Disorder Questionnaire for screening bipolar disorder: a meta-analysis. Depress Anxiety. 2015;32(7):527-538. PubMed
MDQ vs other bipolar spectrum scales
| Test | Items | Time | Best for | Administered by |
|---|---|---|---|---|
| MDQ | 15 (13+2) | 3 min | Lifetime screen for bipolar spectrum | Self-report |
| HCL-32 | 32 | 5 min | Hypomania screening when bipolar II is suspected | Self-report |
| BSDS (Bipolar Spectrum Diagnostic Scale) | Narrative + checklist | 5 min | Bipolar spectrum including softer variants | Self-report |
| YMRS (Young Mania Rating Scale) | 11 | 15 min | Current mania severity | Clinician |
Use MDQ as first-line bipolar screener at every depression evaluation. Add HCL-32 if bipolar-II is suspected but MDQ is negative or borderline.
When to act on your MDQ result
- Negative screen: Bipolar spectrum less likely. If you have concerns about hypomanic-adjacent symptoms not captured by MDQ, take HCL-32 as a more sensitive Bipolar-II screener.
- Not sure you want the clinical version? The plain-English Am I bipolar? test explains the same pattern in everyday language.
- Positive screen (any severity): Clinical evaluation with a psychiatrist. Bring the MDQ result plus any past depression treatment records. Formal differential diagnosis will assess for Bipolar I, Bipolar II, Cyclothymia, ADHD, and Borderline Personality features.
- Positive screen while on antidepressants: Discuss with your prescriber urgently. Antidepressant-induced hypomania or mixed features are common when unrecognised bipolar depression is treated with SSRI/SNRI monotherapy. Do not stop medication on your own.
- Positive screen with severe depression: If you have current major depression AND a positive MDQ screen, treatment planning differs meaningfully from unipolar depression (mood stabilisers usually first, antidepressants added cautiously, often alongside structured psychotherapy such as CBT or family therapy). Same-week clinical evaluation.
After the MDQ
- Bring the report to consultation. The MDQ result plus any prior depression treatment records are the fastest way to give a psychiatrist a bipolar differential at intake.
- Track over time. MDQ is a lifetime screener, not a treatment-response monitor. Once diagnosed, YMRS is used for current-state mania severity and PHQ-9 / HAM-D / MADRS for depression severity.
- Screen depression severity. Take PHQ-9 or HAM-D alongside for current depression severity.
- Family history matters. Bipolar is more heritable than unipolar depression. A positive MDQ plus a family history of bipolar or completed suicide substantially increases the pre-test probability of bipolar spectrum.
- Book a specialist. Mindtalk's psychiatrists with bipolar spectrum expertise treat mood disorders across Bangalore, Hyderabad, Mysore, and online for anywhere in India.
How to take the MDQ
- 1
Open the MDQ in the Mindtalk app
Tap "Take the MDQ" to open the assessment. You will need a free Mindtalk account — sign-in takes under a minute.
- 2
Answer Section 1 — 13 lifetime yes/no items
For each of the 13 symptoms, answer whether there has ever been a period of your life when this was true (not necessarily currently).
- 3
Answer Section 2 and 3 — co-occurrence and impairment
Section 2 asks whether several of the Section 1 symptoms happened at the same time. Section 3 asks how much these symptoms caused problems in work, family, or social function.
- 4
Get your screen result and next-step recommendation
Receive a positive or negative screen result and a personalised next-step recommendation. Positive screens route to clinical evaluation.
Related assessment guides
PHQ-9
A quick 3-minute self-check for depression using the PHQ-9 — the global clinical standard. Instant score, severity band, and next-step recommendation. Free in the Mindtalk app.
Read the guide →BDI-II (explained) → PHQ-9 (alternative)
The Beck Depression Inventory — the classic 21-item depression measure. Learn what it is, when to use it, and take the free PHQ-9 alternative in the Mindtalk app.
Read the guide →DASS-21
Measure depression, anxiety, and stress in a single 21-item scale. 4 minutes, three scores, instant clinical bands. Free in the Mindtalk app.
Read the guide →EPDS
The gold-standard postnatal depression screener. 10 questions, 3 minutes, instant score with clinical context. Free in the Mindtalk app.
Read the guide →HAM-D / HDRS-17
The clinician-administered depression severity gold standard since 1960. 17 items, 8 minutes, instant score bands. Free in the Mindtalk app.
Read the guide →MADRS
The clinician-administered depression scale designed to detect medication response — 10 items, 5 minutes, instant clinical bands. Free in the Mindtalk app.
Read the guide →Frequently Asked Questions
- How accurate is the MDQ?
- In the 2000 validation study (198 outpatients at mood-disorder clinics), a screen of 7 or more items gave 73% sensitivity and 90% specificity. In a US general-population study, sensitivity was only 28% and specificity 97%. A 2015 meta-analysis of 21 studies found pooled sensitivity of 62% and specificity of 85%, but among depressed patients without a known bipolar diagnosis sensitivity fell to 37%. So a positive MDQ is a strong prompt for assessment, while a negative MDQ does not rule bipolar out.
- What does a positive MDQ screen mean?
- A positive screen means your response pattern is consistent with bipolar spectrum at a level warranting clinical evaluation. It is not a diagnosis. Formal bipolar diagnosis requires clinical interview (DSM-5 or ICD-11 criteria), family history, illness course over time, and ruling out substance-induced mood episodes, ADHD, borderline personality, and cyclothymia. Roughly 3-5% of the general population meets lifetime bipolar-spectrum criteria; a positive MDQ increases that probability but does not confirm it.
- Why is bipolar under-diagnosed?
- Three reasons. First, the person seeks help during depression (not during mania or hypomania — which feel good), and clinicians don't always ask systematically about past highs. Second, bipolar-II hypomania is often experienced as productivity, not illness — so it's under-reported. Third, diagnosis is often slow: a 2017 meta-analysis put the average gap between onset and management at 5.8 years. This is why the MDQ was invented — to systematically ask about past highs at every depression evaluation. Undetected bipolar depression treated with SSRIs can trigger switch to mania.
- What if I score positive on MDQ but doubt I'm bipolar?
- Common. High MDQ scores also occur in ADHD (item overlap on racing thoughts, distractibility, over-activity), borderline personality disorder (rapid mood shifts), substance use (stimulant intoxication mimics hypomania), and PTSD (hyperarousal). A positive MDQ is a starting point for clinical conversation, not an end point. Bring the result to a psychiatrist for structured differential diagnosis.
- Should I take MDQ if I'm on antidepressants?
- Yes, especially if antidepressants haven't worked, have worked partially, or have caused agitation, irritability, insomnia, or 'buzzy' energy. Antidepressant-induced hypomania is a well-known clinical event; a positive MDQ in this context strongly suggests underlying bipolar spectrum. Do NOT stop antidepressants on your own based on MDQ result — bring the result to your prescriber and discuss.
- Is the MDQ validated in India?
- We could not find a published Indian validation study of the MDQ, so we do not claim one. The 2015 meta-analysis of 21 studies found no significant difference in its accuracy between studies from Eastern and Western countries after adjusting for clinical differences. It is used in Indian psychiatric practice, including at Cadabams, as a first screen before clinical interview.
- What does MDQ mean?
- MDQ stands for Mood Disorder Questionnaire, a screening questionnaire for bipolar spectrum disorders (bipolar I, bipolar II and related conditions). It was published in 2000 by Robert Hirschfeld and colleagues. In medicine, MDQ almost always refers to this bipolar screener.
- How do I take the MDQ?
- Click 'Take the MDQ'. Complete all three sections (2-3 minutes), receive your screen result (positive or negative), and get a personalised next-step recommendation. Free in the Mindtalk app.
Need a clinician's read on your results?
A high score is a signal, not a diagnosis. Mindtalk's psychiatrists and clinical psychologists can interpret your results and recommend next steps — same-day appointments available.