What the MDQ can find, and what it cannot decide
People often seek help while depressed, exhausted, or unable to focus. They may forget a past period of much less sleep, faster speech, risky choices, heavy spending, or unusual energy. MDQ helps bring that episode into the conversation. ADHD, trauma, anxiety, substances, medicines, thyroid disease, and sleep loss can cause similar answers.
Lifetime history
Was there a period unlike your usual self?
The screen looks for a cluster of elevated or irritable mood, energy, activity, sleep, thought, speech, confidence, and risk-taking changes.
Episode
Did several changes happen together?
Seven isolated yes answers across different years do not meet the standard scoring rule.
Consequence
What did the period cost?
Sleep, work, school, money, driving, relationships, safety, and what other people noticed make the screen clinically useful.
Limit
Could another condition explain the answers?
ADHD, trauma, anxiety, personality patterns, substances, medicines, thyroid disease, sleep loss, and other illness can overlap or coexist.
A diagnostic assessment needs several things: how long episodes last, how severe they are, and how you function. It also needs depression history, what family members have seen, psychosis, safety, medicines, substances, medical causes, and what happens between episodes. MDQ is one entry point into that work.
Save this test
Save the episode evidence, not only 'positive' or 'negative'
Keep the form with the lifetime episode history so the clinician can compare the score with what really happened.
Record the next step: a full assessment, medicine review, safety plan, or urgent care.
How do age, sex, pregnancy, postpartum timing, and other conditions affect the MDQ?
The adult MDQ uses the same score rules for males and females. Age, development, pregnancy, time after birth, medicines, substances, sleep, and care setting change the follow-up.
Children
The adult MDQ isn't for diagnosing a child. Bipolar-like symptoms overlap with ADHD, anxiety, depression, conduct problems, trauma, sleep disorders, medicines, substances, and ordinary development. NIMH and NICE support specialist child assessment using episode duration, function, development, family input, and longitudinal observation.
Teenagers
The MDQ-Adolescent Version is separate. In 104 adolescent psychiatric outpatients, the parent version at five or more items had sensitivity 0.72 and specificity 0.81 and outperformed self-report versions. Those figures do not validate an adult online MDQ or diagnose a teenager.
Adult women and men
Standard adult scoring is the same. A hypomanic episode may be missed for different reasons, including depression-led help-seeking, stigma, substance use, anger or irritability labels, reproductive timing, or a lifelong ADHD history. Weigh the episode and how daily life changed, not sex stereotypes.
Pregnancy and postpartum
Bipolar screening belongs before treatment for depression or anxiety when it has not been done. After birth, very little need for sleep with extreme energy, confusion, paranoia, hallucinations, or dangerous behavior needs urgent help. So does being unable to care for yourself or the baby.
Older adults and first episodes later in life
A first activated or psychotic episode later in life needs a careful medicine, substance, sleep, neurological, endocrine, and physical-health review. A positive lifetime questionnaire doesn't settle whether the cause is bipolar disorder, delirium, dementia, thyroid disease, steroids, another medicine, or another illness.
People with ADHD, trauma, anxiety, personality, or substance histories
These conditions can occur with bipolar disorder or cause similar yes answers. Ask whether several changes started together, differed from the person's usual lifelong traits, lasted a clear time, and changed daily life or judgment.
How to complete and discuss an MDQ accurately
Use an authorized adult MDQ form in a language you understand. The original wording is copyrighted. An online rewording, a shortened quiz, or a score from a site that doesn't show its version and scoring rule can't replace the authorized form.
Answer about any clear lifetime period when you were not your usual self. Do not count a single ordinary late night, a deadline, a holiday, caffeine alone, or a lifelong trait unless several changes formed the same distinct episode.
For each yes, note one real example and an approximate date. Add what changed in ordinary life and whether someone else noticed that you were markedly different from usual.
Save all three score parts. Record the number of yes answers, whether several happened together, and whether the period caused no, minor, moderate, or serious problems.
Bring depression and family history, pregnancy or postpartum timing, admissions, psychosis or safety events, plus a complete medicine and substance timeline. Include missed doses and major sleep loss. Do not stop a medicine before the review.
Get urgent help if you are sleeping very little without feeling tired and becoming hard to stop or acting dangerously. Get help now for hallucinations, unusual beliefs, suicidal thoughts, risk to others, or being unable to care for yourself or a baby.
Use the authorized adult form
Keep the exact language, version, date, setting, and person who asked you to complete it.
Answer for a distinct lifetime period
Look for a clear change from your usual self, not isolated traits from different years.
Keep symptoms in the same episode
The standard screen requires several endorsed symptoms to have happened during the same period.
Name what really changed
Write what changed in sleep, work, school, money, driving, relationships, safety, or ordinary judgment.
Use the result to build the interview
A positive result or a strong episode history needs a full clinical assessment, whatever the score says.
How to understand a positive or negative MDQ result
Read the authorized form in order. Save all 13 answers, the yes count, whether symptoms happened together, and how much trouble they caused. Then add episode length, sleep need, daily changes, what others saw, medicines, substances, and current safety.
Not scoreable yet
Incomplete, paraphrased, wrong version, or missing the same-period or problem question
This result is neither positive nor negative. Save the answers and repeat only with the correct authorized form or use the episode history directly in a clinical interview. A copied online score without version and scoring details is not comparable.
Standard adult screen not positive
One or more score parts were not met. Bipolar II or a poorly remembered, short, or less harmful high period may still need review when the history fits.
Standard adult screen positive
Standard adult positive screen: at least 7 of 13 symptoms, same period, and moderate or serious problems
Arrange a fuller bipolar assessment. Bring each yes answer, episode dates, sleep need, daily changes, what family saw, depression history, medicines, substances, and any safety concerns.
Current symptoms need urgent assessment
Current marked activation, psychosis, severe depression, or danger, whatever the MDQ result
Seek urgent mental-health help for dangerous behavior, suicidal intent, risk to others, hallucinations, severe confusion, or rapidly worsening agitation. Get urgent help if you cannot care for yourself or a baby.
A negative MDQ can miss bipolar II
The form is better at detecting bipolar I than bipolar II and performs differently outside specialist mood settings. A clear past episode of less sleep, more energy or activity, and changed judgment still deserves assessment even when the standard screen is negative.
See research details
Accuracy numbers belong to the study population and scoring method that produced them.
Save all three parts and the individual answers. The result isn't a 0-to-13 severity score, and seven isolated yes answers aren't a positive screen.
Those percentages aren't your personal odds. The original sample already had a high reason to suspect a mood disorder, and standard scoring includes the two supplementary parts.
Performance changes with prevalence, setting, interview method, scoring, and bipolar subtype.
If depression alternated with distinct periods of less sleep, more energy or activity, changed judgment, or behavior noticed by others, keep that history visible even when MDQ is negative.
Read each accuracy number with its study's population, version, language, cutoff, and diagnostic interview.
Repeated MDQ totals aren't a way to measure recovery. Save the actual episode and current-function record, and use a clinician-chosen monitoring tool when tracking treatment.
Use the alternate postpartum cutoff score only in that setting. Pregnancy or postpartum activation, psychosis, severe insomnia, confusion, or thoughts of harming self or baby needs urgent perinatal mental-health assessment.
Follow the process your care service uses. A screening page can't replace a diagnostic interview, risk assessment, physical review, or local referral route.
What you can do after an MDQ result
Use the result to protect sleep and safety, build a timeline, and delay risky choices until a full assessment.
Build one episode timeline
For each high or irritable period, record the start, end, sleep need, energy, speech, thoughts, and activity. Add spending, driving, sex, conflict, work or school changes, unusual beliefs, and what happened before and after. Keep depressed periods on the same timeline.
Ask a trusted person what they saw
With your consent, ask someone who knew you during the period what changed from your usual behavior and how long it lasted. Save concrete observations, not an argument about a diagnosis. Clinical guidance values corroborating history because reduced insight can be part of an episode.
Protect sleep and lower stimulation
Keep a regular chance to sleep, reduce unnecessary all-night work and high stimulation, and avoid using alcohol or recreational drugs to force sleep or energy. If you're getting more hyper, or sleeping very little without feeling tired, get assessed instead of trying to fix it alone.
Postpone decisions that can wait
NICE advises avoiding major decisions during mania or hypomania. Delay large purchases, money transfers, sudden travel, public posts, and treatment changes. Do not drive when unsafe. Ask a trusted person to help limit access when needed.
Make every medicine and substance visible
Record any antidepressants, stimulants, steroids, decongestants, thyroid hormone, sleep medicines, missed doses, supplements, alcohol, cannabis and recreational drugs next to the dates of your symptoms. Do not stop or restart a prescription from the screen; contact the prescriber when activation followed a change.
In the US, call or text 988 for suicidal thoughts or an emotional crisis. Call 911 for immediate danger. Seek urgent help for danger to yourself or others, hallucinations, severe confusion, or being unable to care for basic needs or a baby.
What to save with an MDQ result
Keep these together
- Authorized version, language, date, setting, all 13 answers, yes-count, same-period answer, and problem rating
- Possible episode start, end, duration, sleep need, energy, speech, thoughts, activity, confidence, spending, driving, sex, conflict, and risk
- What changed at work, school, home, financially, socially, and what a trusted person noticed
- Depression history, family history, psychosis, admissions, suicide or safety events, pregnancy and postpartum timing
- Complete medicine and substance timeline, clinician interpretation, and next decision
Question for the visit
“Do these MDQ answers describe one distinct episode that differed from my usual self? What history or assessment would separate bipolar disorder from ADHD, trauma, anxiety, personality patterns, substances, medicines, sleep loss, thyroid disease, or another cause?”
Sources for Mood Disorder Questionnaire (MDQ)
Original adult form, 13 symptom prompts, same-period question, problem rating, standard positive-screen rule, copyright, and non-diagnostic statement.
Original 198-patient mood-clinic development and validation, sensitivity, specificity, and population limit.
US general-population validation, 85,358 respondent frame, 695 interviews, and low-sensitivity limit.
Adult MDQ review, setting dependence, bipolar I and II sensitivity difference, predictive values, and routine-use concerns.
Population sample of women, low sensitivity, false positives, and missed bipolar II cases.
Accuracy meta-analysis, primary-care and general-population performance, and bipolar II limit.
Ninety-three-study meta-analysis, 62,291 participants, pooled screening performance, and diagnostic-confirmation boundary.
Three-month MDQ reliability in 331 adults with diagnosed bipolar disorder and limit on repeat-score tracking.
Separate parent MDQ-A performance in 104 adolescent psychiatric outpatients.
Selected two-to-four-week postpartum clinic validation, standard and alternate scoring, and perinatal limit.
Current US recommendation to screen for bipolar disorder before depression or anxiety pharmacotherapy when not previously done.
Episode symptoms, duration, diagnosis, medical and substance mimics, coexisting conditions, treatment boundary, self-help, and US crisis action.
UK primary-care questionnaire restriction, four-day overactivity referral question, diagnostic assessment, differential diagnoses, risk, children, and practical safety.
Australian episode, diagnosis, function, medical review, and urgent-care context.
Current US crisis contact for suicidal thoughts or emotional crisis.
See each claim's sources
range
The standard adult MDQ screen requires at least 7 of 13 symptom prompts, co-occurrence during the same period, and moderate or serious problems.limitation
MDQ is a screening instrument and does not diagnose bipolar disorder or select treatment.context
The original 198-patient mood-clinic validation reported sensitivity 0.73 and specificity 0.90 at seven or more symptom items.limitation
A US general-population study reported sensitivity 0.281 and specificity 0.972, demonstrating that performance changes by setting.limitation
Adult review evidence found lower MDQ sensitivity for bipolar II than bipolar I.limitation
Meta-analytic MDQ sensitivity and specificity vary by setting, cutoff, subtype, and included population and are not personal probabilities.limitation
A 2026 three-month study in 331 adults with bipolar disorder found low MDQ internal consistency and moderate test-retest reliability.context
The separate parent-completed MDQ-A had sensitivity 0.72 and specificity 0.81 at five or more items in 104 adolescent psychiatric outpatients.context
US obstetric guidance supports bipolar screening before depression or anxiety pharmacotherapy when not previously done, and a selected postpartum study used different alternate scoring.context
NICE advises against questionnaires in primary care to identify adult bipolar disorder, while US obstetric guidance includes bipolar screening within a follow-up system.safety
Current mania, psychosis, severe depression, suicidal intent, or danger requires urgent assessment regardless of MDQ score.