title: Impact of axis-I comorbidity and suicidal behavior disorders on sensitivity and specificity of the Mood Disorder Questionnaire in complex depressed inpatients.
abstract: OBJECTIVE
  This study assessed the psychometric performance of the Mood Disorder Questionnaire (MDQ) and its modified MDQ7 version, to screen for bipolar disorders (BD) in depressive inpatients according to depression severity, number of current axis I psychiatric comorbidities and suicidal behavior disorders.
  
  
  METHODS
  Depressed adult inpatients (n=195) were consecutively enrolled. Psychiatric diagnoses were made using the standardized DSM-IV-TR structured interview MINI 5.0.0 and medical case notes. Depression severity was assessed with the Beck Depression Inventory and the Hamilton Depression Scale. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each MDQ version were evaluated in the whole sample and according to depression severity, current axis I psychiatric comorbidities and suicidal behavior.
  
  
  RESULTS
  The occurrence and the number of axis I disorders affected performance of both versions. Among depressed patients with two or more comorbidities, PPV and NPV of the MDQ were 65% and 80%, respectively, and they were respectively 56.2% and 87.9% with MDQ7. Current suicidal behavior disorders also dramatically reduced the PPV of MDQ (from 81.2% to 63.3%) and MDQ7 (from 72.2% to 52.6%) but the NPV remained above 80%. The performance of both versions of the MDQ tended to improve with the severity of depression.
  
  
  CONCLUSIONS
  The MDQ is not a suitable screening instrument to diagnose BD in subjects with a complex major depressive episode and/or a current history of suicidal behavior. Nevertheless MDQ particularly in its modified version may be useful for ruling out the presence of BD among these complex patients.
authors.affiliation: Psychiatric Department, CHU Nîmes, Hopital Carémeau, Nîmes, France; Inserm U1061 Montpellier, France; University of Montpellier 1, Montpellier, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Cyprien
authors.affiliation: Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France. Electronic address: s-guillaume@chu-montpellier.fr.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Guillaume
authors.affiliation: Inserm U1061 Montpellier, France; University of Montpellier 1, Montpellier, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaussent
authors.affiliation: Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France; Department of Psychiatry, IIS-Fundacion Jimenez Diaz, CIBERSAM, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lopez-Castroman
authors.affiliation: CHU Montpellier, Information Medical Department, Montpellier, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Mercier
authors.affiliation: Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Olie
authors.affiliation: Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D005602:France; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult