Abstract

BackgroundThe Mood Disorder Questionnaire (MDQ) is a well-recognized screening tool for bipolar disorder, but its Chinese version needs further validation. 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.Methods142 consecutive patients with an initial DSM-IV-TR diagnosis of a major depressive episode were screened for BPD using the Chinese translation of the MDQ and followed up for one year. The final diagnosis, determined by a special committee consisting of three trained senior psychiatrists, was used as a 'gold standard' and ROC was plotted to evaluate the performance of the MDQ. The optimal cut-off was chosen by maximizing the Younden's index.ResultsOf the 142 patients, 122 (85.9%) finished the one year follow-up. On the basis of a semi-structured clinical interview 48.4% (59/122) received a diagnosis of unipolar depression (UPD), 36.9% (45/122) BPDII and 14.8% (18/122) BPDI. At the end of the one year follow-up,9 moved from UPD to BPD, 2 from BPDII to UPD, 1 from BPDII to BPDI, the overall rate of initial misdiagnosis was 16.4%. MDQ showed a good accuracy for BPD: the optimal cut-off was 4, with a sensitivity of 0.72 and a specificity of 0.73. When BPDII and BPDI were calculated independently, the optimal cut-off for BPDII was 4, with a sensitivity of 0.70 and a specificity of 0.73; while the optimal cut-off for BPDI was 5, with a sensitivity of 0.67 and a specificity of 0.86.ConclusionsOur results show that the Chinese version of MDQ is a valid tool for screening BPD in a group of patients with current depressive episode on the Chinese mainland.

Highlights

  • The Mood Disorder Questionnaire (MDQ) is a well-recognized screening tool for bipolar disorder, but its Chinese version needs further validation

  • Our results show that the Chinese version of MDQ is a valid tool for screening bipolar disorder (BPD) in a group of patients with current depressive episode on the Chinese mainland

  • Patients with BPDI differed from patients with BPDII in illness course and the proportion of recurrent depression: Compared to patients with unipolar depression (UPD), the former consisted of higher percentage of patients with recurrent depression while the latter experienced a longer illness course

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Summary

Introduction

The Mood Disorder Questionnaire (MDQ) is a well-recognized screening tool for bipolar disorder, but its Chinese version needs further validation. 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. Many studies have reported that patients with BPD are frequently misdiagnosed with other disorders. Over-diagnosis of BPD is reported to be common. Using the Mood Disorder Questionnaire (MDQ) [5] is one of the common strategies. A Chinese version of MDQ (Additional file 1: Chinese version of Mood Disorder Questionnaire) is a useful screening tool for BPD in a psychiatric population but not in the general population in Hong Kong [9,10]. The psychometric properties of MDQ were found to differ slightly under different language settings and among different populations [6,7,8,9]

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