title: Screening for bipolar disorder with the Mood Disorders Questionnaire in patients diagnosed as major depressive disorder - the experience in China.
abstract: BACKGROUND
  Bipolar disorder (BD) is often misdiagnosed as a major depressive disorder (MDD). This study aimed to test the usefulness of the screening tool, the Mood Disorders Questionnaire (MDQ), to identify BD patients misdiagnosed as MDD in Chinese clinical settings.
  
  
  METHODS
  A total of 1487 patients treated for MDD were consecutively examined in 13 mental health centers in China. The patients' socio-demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The MDQ was completed by patients to identify symptoms characteristic of BD. DSM-IV diagnoses were established using the Mini International Neuropsychiatric Interview (MINI).
  
  
  RESULTS
  Three hundred-nine of the 1487 patients (20.8%) satisfied DSM-IV criteria for BD; 118 (7.9%) for BD-I and 191 (12.8%) for BD-II on the MINI. The optimal cut-off point on the MDQ to differentiate BD from MDD was 3, while cut-off points of 5 and 3 differentiated BD-I and BD-II from MDD, respectively. The maximum sensitivity was 0.31, 0.45 and 0.22 for differentiating BD, BD-I and BD-II from MDD, respectively.
  
  
  CONCLUSIONS
  The optimal cutoff points of the MDQ for screening BD in Chinese patients originally diagnosed as MDD were considerably lower than those in earlier studies. The routine clinical use of the MDQ as a screening scale for BD in Chinese patients treated for MDD does not seem to be justified.
authors.affiliation: Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Hu
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.forename: Faith B
authors.initials: FB
authors.lastname: Dickerson
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Kelly Y C
authors.initials: KY
authors.lastname: Lai
authors.forename: Tian-Mei
authors.initials: TM
authors.lastname: Si
authors.forename: Yi-Ru
authors.initials: YR
authors.lastname: Fang
authors.forename: Zheng
authors.initials: Z
authors.lastname: Lu
authors.forename: Hai-Chen
authors.initials: HC
authors.lastname: Yang
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.forename: Zhi-Yu
authors.initials: ZY
authors.lastname: Chen
authors.forename: Yi
authors.initials: Y
authors.lastname: Huang
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Wang
authors.forename: Hui-Chun
authors.initials: HC
authors.lastname: Li
authors.forename: Jin-Bei
authors.initials: JB
authors.lastname: Zhang
authors.forename: Helen F K
authors.initials: HF
authors.lastname: Chiu
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis*; D002681:China; D003865:Major Depressive Disorder / Q000175:diagnosis*; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires