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.
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 — the observation that people with bipolar spectrum spent an average of 8-10 years being treated for unipolar depression before correct diagnosis.
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.
Subsequent validation studies confirmed the 73% sensitivity for Bipolar I but the lower sensitivity for Bipolar II (39%). This led to the development of the HCL-32 (Hypomania Checklist) as a more sensitive Bipolar II screener — many clinicians now use MDQ + HCL-32 together for full bipolar spectrum coverage.
The MDQ is recommended by the Indian Psychiatric Society, NIMHANS clinical guidelines, the International Society for Bipolar Disorders, and most global bipolar treatment guidelines for routine use at every depression evaluation.
MDQ vs other bipolar spectrum scales
| Test | Items | Time | Best for | Sensitivity — BP I / BP II |
|---|---|---|---|---|
| MDQ | 15 (13+2) | 3 min | Classic bipolar screening | 73% / 39% |
| HCL-32 | 32 | 5 min | Bipolar II screening — more sensitive to hypomania | ~80% / ~80% |
| BSDS (Bipolar Spectrum Diagnostic Scale) | Narrative + checklist | 5 min | Bipolar spectrum including softer variants | Comparable to MDQ |
| YMRS (Young Mania Rating Scale) | 11 | 15 min | Clinician-administered current mania severity | N/A — current state only |
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.
- 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). 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.
Frequently Asked Questions
- How accurate is the MDQ?
- The MDQ has 73% sensitivity and 90% specificity for Bipolar I Disorder against structured clinical interview. It has 39% sensitivity for Bipolar II — meaning it misses more than half of bipolar-II cases. This is because bipolar-II hypomanic episodes are shorter, less impairing, and often experienced as 'good moods' rather than pathological, so people don't endorse the MDQ items. The MDQ works best when the person has had classic manic episodes; it under-detects softer bipolar spectrum presentations. A negative MDQ does NOT rule out bipolar disorder.
- 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, the average time from first bipolar episode to correct diagnosis is 8-10 years globally. 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?
- Yes. The MDQ has been used in Indian psychiatric practice since 2005 and has translated Hindi, Kannada, and Tamil versions. Indian bipolar prevalence appears similar to global rates, but under-diagnosis is a bigger problem in India than in the West — the MDQ has been recommended for routine use at every depression evaluation in Indian Psychiatric Society and NIMHANS guidelines.
- 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.