title: Diagnosing bipolar disorder in trauma exposed primary care patients.
abstract: OBJECTIVE
  Bipolar disorder (BD) is often under-recognized in non-psychiatric settings, especially in African Americans. The Mood Disorder Questionnaire (MDQ) is a screening instrument proposed to show adequate sensitivity and specificity for bipolar spectrum disorders. The current study is an examination of the usefulness of this instrument in a trauma exposed subgroup of mainly African American patients attending primary care clinics.
  
  
  METHODS
  The sample is a part of a larger study exploring traumatic stress exposure and psychopathology. Consenting patients in 3 academically affiliated primary care clinics were asked to complete the MDQ. Ninety percent of the participants were African American. Diagnostic performance was determined in a trauma exposed subgroup by employing the Structured Clinical Interview for DSM-IV (SCID) as a gold standard.
  
  
  RESULTS
  Of the total group of 579 participants, 178 (30.7%) screened positive for BD along with 77 (33.7%) of the 228 trauma exposed subjects who were SCID interviewed. Only 13 (27%) of the MDQ positives met SCID criteria for BD and were true positives. The sensitivity was 61.9% and the specificity was 69%, with a positive predictive value of 16.8% and a negative predictive value of 94.7%.
  
  
  CONCLUSIONS
  The MDQ was found to have low specificity in a predominately African American group of trauma exposed patients attending primary care.
authors.affiliation: Howard University School of Medicine, Washington, DC 20011, USA. revelainegraves@att.net
authors.forename: Ruth Elaine
authors.initials: RE
authors.lastname: Graves
authors.forename: Tanya N
authors.initials: TN
authors.lastname: Alim
authors.forename: Notalelomwan
authors.initials: N
authors.lastname: Aigbogun
authors.forename: Kris
authors.initials: K
authors.lastname: Chrishon
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Mellman
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Charney
authors.forename: William B
authors.initials: WB
authors.lastname: Lawson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D044383:Black People / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data; D011320:Primary Health Care; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D001741:Black or African American