title: The Mood Disorder Questionnaire (MDQ) for detecting (hypo)manic episodes: its validity and impact of recall bias.
abstract: BACKGROUND
  Bipolar disorders often remain unrecognized in clinical practice, which may be a consequence of imprecise recall of manic symptoms earlier in life. This study will therefore examine the validity of the widely-used Mood Disorder Questionnaire (MDQ) in detecting a (hypo)manic episode and explore the impact of recall bias.
  
  
  METHODS
  As an indication of impairments in recalling manic symptoms, we examined the long-term reliability of the MDQ after two years of follow-up in a sample of 2087 persons. Then, the validity of the MDQ was tested against the gold standard of a CIDI-based DSM-IV (hypo)manic episode. Its performance was compared for detecting a lifetime episode (at T1) versus a recent episode in the past two years (at T2).
  
  
  RESULTS
  The long-term reliability of the MDQ was limited as the correct recall of individual items ranged from 44.6% to 68.8% after two years. The overall validity of the MDQ in detecting a lifetime (hypo)manic episode was limited and no adequate cut-off point with acceptable sensitivity and specificity could be identified. However, the MDQ accurately detected a recent episode with a sensitivity of 0.83 and a specificity of 0.82 for the standard and optimal cut-off point of ≥ 7. Taking into account two additional MDQ questions on clustering in time and severity of problems decreased its validity.
  
  
  CONCLUSIONS
  Patients with a primary, clinical diagnosis of bipolar disorder were excluded.
  
  
  CONCLUSIONS
  The MDQ accurately detected recent (hypo)manic episodes, but imprecise recall may result in a limited performance for episodes earlier in life.
authors.affiliation: Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE)/University Center Psychiatry (UCP), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. l.boschloo@umcg.nl
authors.forename: Lynn
authors.initials: L
authors.lastname: Boschloo
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.forename: Annet T
authors.initials: AT
authors.lastname: Spijker
authors.forename: Erik
authors.initials: E
authors.lastname: Hoencamp
authors.forename: Ralph
authors.initials: R
authors.lastname: Kupka
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schoevers
mesh_terms: D000328:Adult; D015982:Bias; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D011569:Psychiatric Status Rating Scales / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
keywords: Bipolar disorder; Mood Disorder Questionnaire; Reliability; Validity