Bipolar - Do You Know It?: MOOD DISORDER QUESTIONNAIRE (MDQ)

MOOD DISORDER QUESTIONNAIRE (MDQ)

INSTRUCTIONS: If you think you may have bipolar disorder, take some time to fill out this questionnaire, print it out and share it with your doctor or a mental health professional. The questionnaire can help determine if you are experiencing any symptoms of bipolar disorder. It is not intended to provide a diagnosis. Only a doctor or mental health professional can make a proper diagnosis.
This screening test is not appropriate for, and should not be completed by, persons under age 18. Persons under age 18 with symptoms of bipolar disorder are advised to talk with their parents or guardians about seeing a physician or qualified mental health professional for a complete evaluation.

Please answer each question as best you can.

1. Has there ever been a period of time when you were not your usual self and...
	you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble?
	you were so irritable that you shouted at people or started fights or arguments?
	you felt much more self-confident than usual?
	you got much less sleep than usual and found you didn’t really miss it?
	you were much more talkative or spoke much faster than usual?
	thoughts raced through your head or you couldn’t slow your mind down?
	you were so easily distracted by things around you that you had trouble concentrating or staying on track?
	you had so much more energy than usual?
	you were much more active or did many more things than usual?
	you were much more social or outgoing than usual; for example, you telephoned friends in the middle of the night?
	you were much more interested in sex than usual?
	you did things that were unusual for you or that other people might have thought were excessive, foolish or risky?
	spending money got you or your family into trouble?
2. If you answered YES to more than one of the above, have several of these happened during the same period of time? yes no
3. How much of a problem did any of these cause you – like being unable to work; having family, money or legal troubles; getting into arguments or fights? Please check one response only.
No problem Minor problem Moderate problem Serious problem
4. Have any of your blood relatives (i.e., children, siblings, parents, grandparents, aunts, uncles) had manic-depressive illness or bipolar disorder?
	yes no
5. Has a health professional ever told you that you have manic-depressive illness or bipolar disorder?
	yes no

When you have completed the questionnaire, print it out and bring it to your doctor or a mental health professional. This checklist is not a substitute for a complete clinical evaluation.

If you need a referral for professional resources in your community, contact your local Mental Health Association (MHA) or the National Mental Health Association at 800-969-NMHA (6642).

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ACKNOWLEDGEMENT: The Mood Disorder Questionnaire (MDQ) was developed by Robert M. A. Hirschfeld, MD (University of Texas Medical Branch), and published in the American Journal of Psychiatry. (Hirschfeld R, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire. Am J Psychiatry. 2000;157;1873-1875.)

FOR MORE INFORMATION

For more information or referrals for local service contact your local mental health association or:
NMHA Resource Center
  National Mental Health Association
  2000 North Beauregard Street, 6th Floor
  Alexandria, VA 22311
  Phone: 800-969-6642 (NMHA)
  TTY: 800-433-5959
  www.nmha.org