Abstract
Background:The Mood Disorder Questionnaire (MDQ) is a frequently used screening tool for the early detection of Bipolar Disorder (BD), which is often unrecognized or misdiagnosed at its onset. In this study, data from Tunisia has been used to evaluate the psychometric properties of the Arabic MDQ.Methods:The sample included 151 patients with a current major depressive episode. The Arabic adapted version of the Structured Clinical Interview for DSM-IV-TR was used to formulate a diagnosis, yielding 62 patients with BD and 89 with unipolar Major Depressive Disorder (MDD). Principal component analysis with parallel analysis was used to establish the spontaneous distribution of the 13 core items of the MDQ. Confirmatory Factor Analysis (CFA) was used to check the available factor models. Receiver Operating Characteristic (ROC) analysis was used to assess the capacity of the MDQ to distinguish patients with BD from those with MDD.Results:Cronbach’s α in the sample was 0.80 (95%CI: 0.75 to 0.85). Ordinal α was 0.88. Parallel analysis suggested two main components, which explained 59% of variance in the data. CFA found a good fit for the existing unidimensional, the two-factor, and the three-factor models. ROC analysis showed that at a threshold of 7, the MDQ was able to distinguish patients with BD from those with MDD with extraordinary negative predictive value (0.92) and a positive diagnostic likelihood ratio of 3.8.Conclusion:The Arabic version of the MDQ showed good measurement properties in terms of reliability, factorial validity and discriminative properties.
Highlights
Bipolar disorder is a severe condition with estimated lifetime prevalence ranging from 1 to 5% across countries [1], and high risk of functional impairment and suicide [2]
Receiver Operating Characteristic (ROC) analysis was used to assess the capacity of the Mood Disorder Questionnaire (MDQ) to distinguish patients with Bipolar Disorder (BD) from patients with Major Depressive Disorder (MDD)
The sample included 89 patients diagnosed with unipolar major depressive disorder (MDD; 59%), 62 diagnosed with a bipolar spectrum disorder, of whom 22 diagnosed with bipolar disorder type I (14.5%), 37 diagnosed with bipolar disorder type II (24.5%), and 3 diagnosed with Substance-induced Mood Disorder, type: manic (2%)
Summary
Bipolar disorder is a severe condition with estimated lifetime prevalence ranging from 1 to 5% across countries [1], and high risk of functional impairment and suicide [2]. Diagnostic accuracy of the MDQ did not differ significantly between studies from Eastern and Western countries, when taking into account clinical confounding variables [8, 9]. Good accuracy of the MDQ was found in clinical psychiatric settings in the United Kingdom [10], in Italy [11], in France [12], in Spain [13, 14], and in Turkey [15], as well as in community samples in Italy [16] and France [17]. The Mood Disorder Questionnaire (MDQ) is a frequently used screening tool for the early detection of Bipolar Disorder (BD), which is often unrecognized or misdiagnosed at its onset. Data from Tunisia has been used to evaluate the psychometric properties of the Arabic MDQ
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