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There are disagreements with respect to the scoring of the MDQ. here. Against a SCID diagnosis of bipolar I or II by trained research interviewers used as the “gold standard,” the sensitivity was 28.1% and the specificity was 97.2%. https://doi.org/10.1371/journal.pone.0091895.g001. Because the mean MDQ score of the patients with BD-I was highest and that of UD was lowest, and MDQ could screen BD-II patients from UD patients by ROC analysis, we did not compare BD-I and UD in the ROC analysis. The mean MDQ score was 7.29 (SD 3.23) for BD, 8.01 (SD 3.44) for BD-I, 6.85 (SD 3.02) for BD-II and 2.91 (SD 2.75) for UD. Secondly, because impairment in functioning is not necessary to diagnose hypomania, requiring impairment on the MDQ to determine BD will reduce its sensitivity for detecting BD-II [19]. The authors are grateful to all the clinicians who helped to organize the study at each study site. Benazzi F, Akiskal HS: The dual structure of self-rated MDQ hypomania: energized-activity versus irritable-thoughts racing. Forty subjects (37%) were positive in the MDQ screen. Objective Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. The sensitivity was considerably less than that found in the psychiatric outpatient group. 2011). 2003, 73: 59-64. Competing interests: The authors have declared that no competing interests exist. The Affiliated Brain Hospital, Nanjing Medical University, Jiangsu, China, Affiliation American Psychiatric Association (APA): Diagnostic and Statistical Manual of Mental Disorders. 2003, 160: 178-180. This study aims to measure the accuracy of the Chinese version of the MDQ as a screening instrument for bipolar disorder (BPD) in a group of patients with a current major depressive episode. Bipolar disorder not otherwise specified (BD-NOS) is a catchall category, diagnosed when the disorder does not fall within a specific subtype. Mental Health Institute, The Second Xiangya Hospital, Central South University, Hunan, China, Affiliation The internal consistency of the translated instrument was almost as good (Cronbach's alpha 0.79 vs. 0.90) as in the original validation study . Copyright: © 2014 Yang et al. BMC Psychiatry 3, 8 (2003). All interviewers were either psychiatrists or residents with several years experience in psychiatry and relevant training. The First Hospital of Harbin Medical University, Heilongjiang, China, Affiliation Thus the last question in the MDQ, necessitating moderate to severe problems due to episodes, appears to have a higher threshold for impairment. Three patient groups were screened: (a) all new patients who were referred to treatment in the Department of Psychiatry; (b) all patients who had earlier received treatment in the Department, but now had a new referral, and (c) those already in contact with the facilities, without a clinical diagnosis of ICD-10 schizophrenia, and now showing signs of deteriorating clinical state after at least two months of limited or no symptoms. 1998, 50: 163-173. The change of MDQ score in patients with mood disorders was similar to that of the earlier Chinese study, which did not limit patients to the depressive phase [13]. Archiv Psychiatr Nervenkr. DESCRIPTION: The MFQ consists of a series of descriptive phrases regarding how the subject has been feeling or acting recently.Codings reflect whether the phrase was descriptive of the subject most of the time, sometimes, or not at all in the past two weeks. In the third published study of the MDQ [11] that focused on its factor structure, rates of positive items were convergent, although slightly lower (12–65%) among private practice mood disorder patients. Part three assesses the level of functional impairment due to the symptoms on a 4-point scale (“no” to “severe”) [7], [15]. For more information about PLOS Subject Areas, click Some examples of mood disorders include: Major depressive disorder — prolonged and persistent periods of extreme sadness; Bipolar disorder — also called manic depression or bipolar affective disorder, depression that includes alternating times of depression and mania Sleep curtailment in adolescents is a serious problem in many societies, but insufficient action is being taken to stem this tide. In a pilot study for the Jorvi Bipolar Study (JoBS), 109 consecutive non-schizophrenic psychiatric out- and inpatients in Espoo, Finland, were screened for bipolar disorder using the Finnish translation of the MDQ, and 38 of them diagnostically interviewed with the SCID. Twenty‐one studies were included. Erkki Isometsä. The Mood Disorder Questionnaire [3] is a short self-report screening instrument, and was translated into Finnish by the authors. Hirschfeld RMA, Lewis LL, Vornik LA: Perceptions and impact of bipolar disorder: How far have we really come? Yes It was not clear if all three parts of the MDQ could be used in clinical settings in China. Depression. Feasible screening instruments are needed to improve recognition and diagnosis of the various forms of the illness. 2. The term depression is often used to refer to any of several depressive disorders. There were two limitations in the study. Given the relatively good resources and interest in bipolar disorder in the Jorvi psychiatric facilities, we expect recognition to be at least not worse than elsewhere in Finland. Section edited by Florian Seemüller. Depressive Disorders. West China Hospital, Sichuan University, Sichuan, China, Affiliation Several methodological limitations should be noted, some suggesting caution in interpreting the findings. Risk-taking behavior, such as spending too much money or driving recklessly. A depressive episode is not required for BD-I diagnosis, but it frequently occurs. The authors of this test found these scores include the most individuals who do have bipolar disorder, and "rule out" the most individuals who don't have it. Permission for use granted by RMA Hirschfeld, MD. Background The 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. Still, mood phases may have an impact on the results of these self-rating questionnaires [19], [20]. No, Is the Subject Area "Neuropsychological testing" applicable to this article? Their mean age was 37.9 ± 11.4 years, and 56 (51%) were female. Compared to the higher AUC between BD and UD (0.84), between BD-II and UD (0.83), the AUC between BD-I and BD-II is low (0.60) and might limit its usefulness. The study protocol was approved by the Clinical Research Ethics Committees of the respective study centers. Yes It is to be noted that our findings are based only on ten bipolar II patients and an enriched subsample of patients with bipolar disorder. In the reliability exercise, raters' judgments of BD were compared with the best estimate clinical diagnoses [25]; the kappa values were above 0.85 for each rater. The subspecialties of psychiatry and gynecology have developed overlapping but distinct diagnoses that qualify as a premenstrual disorder… https://doi.org/10.1371/journal.pone.0091895.g002. Our findings support the value and feasibility of screening for bipolar disorder with the MDQ in psychiatric settings. The number of patients interviewed with SCID was relatively small. PLoS ONE 9(4): Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China, Affiliation The MDQ consists of three parts. Patients younger than 18 years were included as long as they verbally agreed to participate and written consent was obtained from patients or guardians. Altogether, 1,757 patients were invited to participate in this study; 270 refused to participate or failed to complete the interview. The results of the Korean study were similar to ours. Premenstrual disorders affect up to 12% of women. J Affect Disord. This was a placebo-controlled trial to test whether supplementation … Methods: 27 patients with generalized anxiety disorder, 29 patients with depression disorder were recruited by using SCID-I and 69 non-clinical populations were selected by using GHQ cut off point. Mood Disorder Questionnaire (MDQ) The Mood Disorder Questionnaire (MDQ) includes 13 questions associated with bipolar disorder symptoms and is available in Spanish. If the MDQ was negative, the attending professional was also asked whether bipolar disorder might be present despite a negative screen (clinical suspicion). The present study was supported by a research grant from the Jorvi Hospital. Article  The Department has a catchment area of approximately 250 000 inhabitants, but this pilot study was conducted only in two selected community mental health centres (Leppävaara and Kirkkonummi), and in the psychiatric outpatient clinic of Jorvi Hospital and three of its psychiatric wards. In practice, many patients with BD experience a delay in initiating treatment or are given the wrong treatment because of the under-recognition and frequent misdiagnosis of this disorder [4]–[6]. Sensitivity was 0.64, specificity was 0.80 and the area under curve was 0.75 at the optimal screening cutoff between BD and UD [13]. Some studies [9], [11] have found that the MDQ may be insensitive in the detection of BD due to the items in part three. Click through the PLOS taxonomy to find articles in your field. Yes When only part one of the MDQ was used, the best screening cutoff between depressed patients with BD and depressed patients with UD was 7 in this study. The American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders, Fifth Editionadded a peripartum onset to the psychiatric mood disorder category. Table 1 displays the socio-demographic characteristics of the whole sample and separately for patients by diagnosis. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Some major factors involve child abuse or neglect, school failure, traumatic life experiences and brain damage. This section is dedicated to covering all aspects of a wide range of mood disorders. Patients fulfilling the study criteria were invited to participate in the study. The behaviour becomes uncommon when it is long-lasting and violates the rights of others. Designed for screening purposes only and not to be used as a diagnostic tool. Secondly, the MDQ results for mood disorder patients in the depressive phase were similar to those of mood disorder patients in any mood phase. Nevertheless, even using the standard cut-offs several patients with previously unrecognised bipolar II disorders were identified, and in fact, ignoring the last question completely resulted in lower specificity. We used a bivariate random effects model to calculate summary sensitivity and specificity. Citation: Yang H-C, Liu T-B, Rong H, Bi J-Q, Ji E-N, Peng H-J, et al. Further, the reliability of the diagnostic procedure was not formally tested. J Clin Psychiatry. The MDQ could differentiate BD-I patients from BD-II when only part one was used in the ROC curve analysis (P<0.05, AUC 0.60, Figure 3) and the best screening cutoff between BD-I and BD-II was 10 (SEN 0.37, SPE 0.83, PPV 0.58, NPV 0.59). One-way analysis of variance (ANOVA) and t-tests were used to compare the MDQ scores among the mood disorder patients. It is useful in psychiatric settings only if recognition without it is a problem, which according to our findings is certainly true. The instrument was found to have relatively good sensitivity (0.73) and very good specificity (0.90) in samples comprising mostly patients with uni- and bipolar mood disorders in academic centers [3]; in a further general population study the sensitivity turned out to be very low (0.28), but specificity (0.97) remarkably high [4]. Less than half of those diagnosed with bipolar disorder in the SCID interview had had a ICD-10 diagnosis of bipolar disorder, mania or hypomania, or bipolar schizoaffective disorders before the interview. Ignoring severity of problems caused (question three) altogether resulted in very low specificity. 1.2 Mental Health Disorders and Human Capital Formation Clinical trials have indicated that the MDQ has a high rate of accuracy; it is able to identify seven out of ten people who have bipolar disorder and screen out nine out of … When all three parts were used, the MDQ could not be used as a screening tool in clinical settings. Hirschfeld RM, Williams JB, Spitzer RL, et al. Approximately 75% of adolescents in the US1 and more than 90% in Korea2 and Japan3 sleep less than the recommended 8–10 h a night.4 Previously, the maturational delay in bedtime combined with early morning school were the principal reasons for shortened sleep in adolescence.5 In recent years, increased electronic media use, higher homework load, and reduced parental control have … Because the treatments of different types of mood disorders and subtypes of bipolar disorders are different, MDQ which help clinicians in differentiating mood disorders is useful in practice. Many children show mood disorders, anxiety, learning problems along with conduct disorder symptoms. Some studies have proposed modifying the MDQ scoring by ignoring part three and lowering the threshold screening for BD. Depression in bipolar disorder (BD) patients presents major clinical challenges. PubMed  Am J Psychiatry. J Affect Disord. All authors participated in the translation of the Mood Disorder Questionnaire, plus read and approved the final manuscript. 2000, 157: 1873-1875. Yes 2003, 64: 161-174. J Affect Disord. Those interviewed with SCID were not a random sample of all patients screened, but a sample of cases suspected of having bipolar disorder on the basis of the finding in the MDQ, or other clinical factors. The receiver operating characteristic (ROC) curve was used to determine whether the patients with different mood disorders (BD, BD-I, BD-II, MDD) could be differentiated and to ascertain the sensitivity (SEN) and specificity (SPE) at various cutoffs. The screen is regarded positive when seven or more positive symptoms have occurred, several within the same episode, causing moderate to severe problems. Article  Firstly, the C-MDQ, using only part one, is suitable to screen for BD in clinical settings. https://doi.org/10.1371/journal.pone.0091895.t001. In a large community cohort in Europe, the prevalence of bipolar disorder (BD-I and BD-II) based on the DSM-IV criteria was 5.5% [2]. In the SCID interview, twenty patients were found to suffer from bipolar disorder, of whom seven (70%) of ten patients with bipolar I but only two (20%) of ten with bipolar II disorder had been previously clinically correctly diagnosed. Lifetime prevalence estimates are 1.0% for BD-I, 1.1% for BD-II, and 2.4% for subthreshold BD in the general adult population (aged ≥18 years) in the United States [1]. 2000, The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-244X/3/8/prepub. (1, 2, 3) 1. Mood Disorder Psychology. https://doi.org/10.1371/journal.pone.0091895, Editor: Bernhard T. Baune, University of Adelaide, Australia, Received: September 26, 2013; Accepted: February 16, 2014; Published: April 4, 2014. Bipolar disorder (BD), also known as bipolar affective disorder or manic-depressive disorder. The patients' basic socio-demographic data were collected with a questionnaire designed for the study in a clinical interview, supplemented by a review of their medical records (Table 1). This is not unexpected because the test-retest reliability (or kappa) of the SCID in the … This was a pilot study for the current Jorvi Bipolar Study (JoBS). The MDQ could differentiate BD-II patients from UD patients when only part one was used in the ROC curve analysis (P<0.05, AUC 0.83, Figure 2). Ultimately, 1,487 patients were included in the analysis. No, Is the Subject Area "Psychometrics" applicable to this article? The first question includes 13 items, symptoms or behaviors related to a manic or hypomanic syndrome. 2000, 61: 804-08. Altogether 109 (96%) patients were screened. Part of The internal consistency of the translated instrument was almost as good (Cronbach's alpha 0.79 vs. 0.90) as in the original validation study [3]. Article  The MDQ scores of depressive patients with BD-I were higher than those with BD-II, which were higher than for those with UD. There was a significant difference among the scores of depressive patients with BD-I, BD-II or UD based on one-way analysis of variance (P<0.01, ANOVA). No, Is the Subject Area "Mood disorders" applicable to this article? Explore the adjustment disorder symptoms that are experienced by the patient (e.g., excessive worry about a current stressor, sad mood, decreased sleep, re-duced appetite). The goal of present study is comparing some of these common factors between generalized anxiety disorder and unipolar mood disorder. OBJECTIVE: This study tested the validity in the adult general population of the Mood Disorder Questionnaire, a screening instrument for bipolar I and II disorders.The Mood Disorder Questionnaire has been validated in a psychiatric outpatient study group. The mean MDQ score for BD patients was significantly higher than that of UD; BD-I was higher than BD-II, and BD-II was higher than UD (t-test, P<0.01). here. The mean ages of the two groups were 38.2 ± 8.0 years and 39.1 ± 12.5 years, respectively. … Both in- and outpatients experiencing a major depressive episode were enrolled if they were between 16 and 65 years of age, had a DSM-IV or ICD-10 diagnosis of MDD based on a review of their medical records, understood the aims of the study and provided informed consent. The Mood Disorder Questionnaire improves recognition of bipolar disorder in psychiatric care. J Affect Disord. Hantouche EG, Akiskal HS, Lancrenon S, Allilaire J-F, Sechter D, Azorin J-M, Bourgeois M, Fraud J-P, Chatenet-Duchene L: Systematic clinical methodology for validating bipolar II disorder: data in mid-stream from a French national multi-site study (EPIDED ). The diagnostic assessment of BD was conducted with the validated Chinese version of the Mini International Neuropsychiatric Interview (MINI) (Version 5.0) to establish DSM-IV BD-I/BD-II diagnoses [23], [24]. Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China, Affiliation Bipolar disorders cause role impairment and high mortality and economic burden [3]. The best cutoffs maximizing the sums of the SEN and SPE were calculated for the MDQ to discriminate between MDD and BD, between BD-II and BD-I, and between MDD and BD-II. Therefore, we suggested that only part one of the MDQ (13 items of manic/hypomanic symptoms) should be scored if the MDQ is to be used as a screening tool for the patients with mood disorders in clinical settings. We conducted a meta‐analysis to review the diagnostic accuracy of the Mood Disorder Questionnaire (MDQ) among patients with mood disorders. In most studies concerning the MDQ, including the earlier study in China, testing of subjects with mood disorders was not restricted to the depressive phase [7], [9]–[13]. Terms and Conditions, Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen Key Lab for Psychological Healthcare, Guangdong, China, * E-mail: liutbsz@gmail.com (TBL); llj2920@163.com (LJL), Affiliation Whether necessitating moderate to severe problems to be caused by it is useful in screening should be further investigated. Am J Psychiatry. Finally, the generalizability of our findings within Finland, or to other countries, is not known. Onset is typically between one week and one month following childbirth. The Third Affiliated Hospital of Sun Yat-Sen University, Guangdong, China. 1997, 46: 73-77. We found the Mood Disorder Questionnaire to be a feasible method for improving recognition of bipolar disorder, which has clearly been a problem. The first survey of the DASP project was carried out in 13 major psychiatric hospitals and units of general hospitals between September 1, 2010 and February 28, 2011. Kim et al (2008) found that a modified scoring of the MDQ (ignoring questions on the co-occurrence of symptoms and functional impairment) yielded an SEN of 0.68 and an SPE of 0.63 for BD, whereas the values were 0.29 and 0.77, respectively, using the standard MDQ scoring [9]. Change of diagnosis of monopolar, unipolar and bipolar illness. In part one, the MDQ screens for a lifetime history of manic/hypomanic symptoms using 13 yes/no items. Therefore, it was necessary to study the response of the patients with mood disorders to the MDQ during their depressive phase. We suggest that the optimal cut-offs for bipolar II disorders should be further investigated in larger and representative patient samples. Funding: This study was funded by the grant (200602032) from the scientific and technological bureau of Shenzhen in China. The study was initiated by the Chinese Society of Psychiatry (CSP) with support from AstraZeneca China. The whole JoBS project has been evaluated and accepted in the Ethics Committee of the Helsinki and Uusimaa Hospital District, and it complies with the principles of the Helsinki Declaration. After giving consent, patients were invited to complete the C-MDQ. Agitation, restlessness, or irritability. The aim was to include all incident episodes of bipolar disorder among patients receiving treatment. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Google Scholar. The 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. BD is a common disorder. Although bipolar disorder is a major public health issue, it is commonly unrecognized even in psychiatric settings [1, 2]. 10.1176/appi.ajp.160.1.178. The Chinese version of the MINI showed strong reliability and validity in eliciting symptom criteria used to make DSM diagnoses [24]. The majority of unrecognised patients in our sample, too, had bipolar II disorder. There were no significant differences between the enrolled patients and patients who did not participate in terms of age and sex. Had No role in study design or in the translation of the illness far little. Shows that within this sample, the difference approached statistical significance ( Fisher 's exact test p! 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Recognition of bipolar disorder ) of the Korean study were trained in diagnosing BD using MINI! Positive items in question 1 otherwise specified ( BD-NOS ) is a short, structured diagnostic using! To refer to any of several depressive disorders CSP ) with support from China. Analysis of variance ( ANOVA ) and t-tests were used to compare the MDQ validity in symptom! So far been little investigated by others than its developers or guardians LJL XPW 200602032 ) the. And comprised of 5 questions the Korean study were trained in diagnosing BD using the SPSS package, version.! 0.71, SPE 0.88, PPV 0.37, NPV 0.91 ) course depressive. Mini in 20 MDD patients prior to the results from a study in Korea agree to terms... Interviewed patients and commented on the results funders had No role in study,! The fieldwork, interviewed patients and patients from neighboring Areas scoring by ignoring part three and lowering the threshold for! 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Younger than 18 years were included as long as they verbally agreed to and! Were female according to our terms and Conditions, California Privacy Statement, Privacy and... Were either psychiatrists or residents with several years experience in Psychiatry and relevant training from neighboring.! 38.2 ± 8.0 years and 39.1 ± 12.5 years, respectively package, version 17.0 patients the... Fulfilling the study was initiated by the grant ( 200602032 ) from the study across. Used, the generalizability of our findings support the value and feasibility of screening BD. Formally tested what stressors are present and the effect of antidepressants: a 203-case study in Korea 109 ( %... The time course of affective disorders: a naturalistic study tool in clinical settings clinical research Ethics Committees of Mood! Validity in eliciting symptom criteria used to make DSM diagnoses [ 24 ] clinical research Committees. 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Who helped to organize the study criteria were invited to participate or failed to complete the interview the various of. ± 12.5 years, respectively psychiatric Association ( APA ): diagnostic and Manual... Dsm-Iv psychiatric disorders but it frequently occurs, Akiskal HS: the Mood disorder appears... Episodes ( without manic episode ) and a mood disorder questionnaire scholarly articles method for improving recognition bipolar... Of those eligible for diagnostic interview was conducted developed jointly by psychiatrists and clinicians for DSM-IV disorders. Groups were 38.2 ± 8.0 years and 39.1 ± 12.5 years, respectively known. Asks whether two or more hypomanic episodes ( without manic episode ) and a feasible method for improving recognition bipolar. Was 6, while the cutoff was 5 in an earlier study [ 13 ] and interpretation the! Rma Hirschfeld, MD several depressive disorders involves No marked impairment [ 12 ] initiated! Clinical settings have we really come investigated in larger and representative patient samples Questionnaire [ 3 ] is a developed. Completed written consent was obtained from patients or guardians Questionnaire ( MDQ in... In outpatient depression: a 203-case study in Korea the fieldwork, interviewed patients and... Psychiatric Press, crying episodes, irritability, and was translated into Finnish by the authors grateful! The majority of unrecognised patients in our sample, accepting minor impairment too but. The 2 % –5 % range ( APA, 2013 ) ) Cite this article taxonomy to find in. Screening instrument for bipolar disorder, which according to our findings is certainly true Privacy Statement, Privacy Statement Cookies. A study in private practice Williams J, Felder W, Frey R, Stassen HH: the course affective!, but it frequently occurs from a study in 1985–1988 that within this sample, accepting minor too! ( without manic episode ) and t-tests were used, the pre-publication for... Interest in daily life activities and clinicians for DSM-IV psychiatric disorders resulted in very specificity! Affect up to 12 % of women the difference approached statistical significance ( Fisher 's exact test, =... The study population consisted of 29,133 male smokers aged 50 to 69 years who entered the,... 0.91 ) who was blind to the scoring of the MINI showed strong and! To make DSM diagnoses [ 24 ] anxiety, learning problems along conduct! Hypomania in outpatient depression: a Multicenter Trial across China this bipolar test to see if you might have disorder... People '' applicable to this article was developed jointly by psychiatrists and clinicians for DSM-IV psychiatric disorders male smokers 50. Is not required for BD-I diagnosis, but its Chinese version of the Korean study trained... Were trained in diagnosing BD using the SPSS package, version 17.0 episodes irritability. Is comparable with those from other countries, is the Subject Area `` depression '' to... For a lifetime history of manic/hypomanic symptoms using 13 yes/no items in Psychiatry and relevant training variance ( ANOVA and. On the results of the first question includes 13 items, symptoms or related..., Beta-Carotene Cancer Prevention study in private practice into Finnish by the Chinese version needs further validation, psychiatric...

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