The MDQ is a self-report screen for bipolar disorder. It asks whether there has ever been a period of manic or hypomanic symptoms, whether they came together, and how much trouble they caused. See the three-part rule for a positive screen, what to do with each result, and how to record it with the free template. The official form is linked from this page.
MDQ result template
FreeMOOD DISORDER QUESTIONNAIRE Date: [Date completed] Patient: [Name or record number, age] Form: [Paper, tablet, or portal; language; read aloud or help given] Reason for screening: [Depression before an antidepressant, poor response to treatment, intake, or other] PART 1 TO PART 3 Part 1 yes count: [Number out of 13; any items left blank] Part 2, same period: [Yes, no, or not answered] Part 3, how much of a problem: [No, minor, moderate, or serious problem] Family history and past diagnosis: [Answers to the two unscored questions, if on the form used] SCREEN RESULT Result: [Positive, negative, or incomplete until a blank part is answered] Rule used: [Standard rule of 7 or more yes, same period, moderate or serious problem; or the modified rule your service uses] HISTORY TAKEN TODAY Periods described: [When, how long, sleep, energy, spending, risks taken, who noticed] Current mood: [Depressed, elevated, mixed, or level, with PHQ-9 or other scores] Other explanations: [Substances, stimulants or steroids, thyroid disease, ADHD, borderline personality, trauma] Collateral: [Partner or family account with consent, or not yet obtained] Impression: [Screen result in words, or working diagnosis] DECISION Next step: [Psychiatric assessment, referral, or watch and review] Medication: [Antidepressant held or started, mood stabilizer, or no change, with the reason] Safety: [Suicidal thoughts asked about directly, and the answer] Follow-up: [Who arranges it and by when] Screened by: [Name, credentials]
Use it for
Give it to people with depression, now or in the past, before you decide on treatment. It matters most when an antidepressant is on the table.
Avoid: Using it as a population screen in people with no mood symptoms. In a general population study it found only 28% of people with bipolar disorder.
The patient completes it alone, on paper or a screen, in about 5 minutes. Hand it over before the visit, so the conversation doesn’t shape the answers.
Avoid: Letting the patient read part 1 as “in the last two weeks”. A depressed patient will answer no to almost everything.
Count the yes answers in part 1, then check parts 2 and 3. A positive screen needs all three.
Avoid: Calling a count of 7 or more positive on its own. A count of 10 with no to part 2 is a negative screen on the standard rule.
A positive screen means bipolar disorder is possible and needs a diagnostic assessment. A negative screen lowers the chance but doesn’t rule it out.
Avoid: Diagnosing bipolar disorder from a positive screen. Even in the original clinic study, 1 in 10 people without it screened positive.
In bipolar depression an antidepressant on its own can bring on mania or a mixed state, so a positive screen changes the next step.
Avoid: Waiting on a routine referral when there is current suicide risk or severe depression. Act on the risk now.
Each one follows the recording template. Use them to judge how much to write.
Primary care clinic, return visit for a third episode of depression, paper form before the appointment
Part 1: 9 of 13 yes, every item answered. Part 2: yes. Part 3: serious problem. Family history: her mother has bipolar I disorder. Past diagnosis: none.
Positive on the standard rule: 9 yes, together in the same period, and a serious problem.
27-year-old woman, a graphic designer, in her third episode of depression since age 19. PHQ-9 today 18. She describes two spells, in 2023 and last spring, each about a week long: 3 to 4 hours of sleep a night without feeling tired, racing thoughts, and several new projects at once. She walked out of a job during the second. Her partner, at the visit with her consent, remembers both. No stimulants or cannabis, 2 drinks a week, TSH normal in August. Impression: possible bipolar disorder, not yet diagnosed.
No antidepressant started today; she agreed once we talked through the risk of bringing on a high. Psychiatry assessment booked for November 24. Asked directly about suicidal thoughts: none; 988 given for a crisis. The practice nurse calls her weekly until the assessment, and she comes in sooner if her sleep drops again.
Community mental health clinic, intake by video, form completed in the patient portal the day before
Part 1: 8 of 13 yes. Part 2: no. Part 3: moderate problem. Family history: none known. Past diagnosis: none.
Negative on the standard rule. The count of 8 meets the item threshold, but he says the symptoms came at different times, not together.
41-year-old man, a restaurant manager, referred with depression that hasn’t lifted on sertraline or venlafaxine. PHQ-9 today 15. Went through his yes answers one by one: the short sleep comes with weekend double shifts, and the fast talk and irritability come with drinking. He has never had 4 or more days in a row of high energy with little need for sleep, and had no highs on either medicine. His wife, joining with his consent, agrees. 4 to 6 beers most nights; AUDIT 18. Impression: major depressive disorder with heavy drinking; no past mania or hypomania found.
Plan treats the depression and the drinking together: referral to the clinic’s addiction counselor and to CBT, and a letter to his family physician for the medicine review. No suicidal thoughts when asked. Ask about highs again at each review, and take a fresh history if new symptoms appear.
Seven or more yes answers is only the first of three conditions. Check the same-period answer and the problem rating before calling it positive.
The MDQ misses many people with bipolar II, whose highs often don’t feel like a problem. When the history points to past highs, assess anyway.
The questions cover the whole lifetime. A positive screen in a depressed patient points to past highs, not current mania.
ADHD, borderline personality disorder, substance use, and anxiety all raise the count. The diagnosis comes from a full history, ideally with someone who knows the patient well.
Vero Scribe records the MDQ result in your template from the visit, with the patient’s consent, or from your dictation: the yes count, parts 2 and 3, the result, the history you took, and the decision. You review and edit every line, then copy it into your record. Vero works in 60+ languages.
Count the yes answers in part 1, from 0 to 13. The screen is positive when there are 7 or more yes answers, part 2 is yes, meaning several of the symptoms happened in the same period, and part 3 is a moderate or serious problem. All three are needed. The background questions on family history and past diagnosis aren’t scored.
That bipolar disorder is possible and needs a diagnostic assessment. It isn’t a diagnosis: in the original clinic study, about 1 in 10 people without bipolar disorder still screened positive, and ADHD, borderline personality disorder, and substance use can all raise the count.
7 or more yes answers out of 13, together with yes to part 2 and a moderate or serious problem in part 3. Some studies drop parts 2 and 3 or use a lower count to find more bipolar II, which finds more people and flags more who don’t have it. Record which rule you used.
Less well than bipolar I. Hypomania often doesn’t feel like a problem, so part 3 is answered no or minor problem and the screen comes out negative. In one clinic study it picked up under a third of people with bipolar II or related forms. When the history suggests past highs, assess anyway.
The MDQ is a self-report screen for a lifetime history of mania or hypomania. The YMRS is rated by a clinician from an interview and measures how severe mania is now, in someone already assessed, on a scale of 0 to 60. One asks whether it ever happened; the other asks how bad it is today.
Often, yes. The PHQ-9 measures current depression but can’t tell depression in bipolar disorder from unipolar depression. Adding the MDQ when depression is found, especially before an antidepressant, checks for past highs.
The HCL-32, a 32-item hypomania checklist, was better than the MDQ at finding bipolar II in mental health settings in a 2015 meta-analysis. The Bipolar Spectrum Diagnostic Scale is another self-report option. Whichever you use, a positive result leads to the same diagnostic assessment.
Yes. The MDQ-A, published in 2006, has a parent answer about their teenager. In an adolescent psychiatry clinic, the parent version with 5 or more yes answers found 72% of teens with bipolar disorder, with 81% specificity; the teens’ own answers did less well.
It’s widely used in clinics, but it’s copyrighted. A copy with the scoring rule, shared with Dr. Hirschfeld’s permission, is on the University of Washington Psychiatry Consultation Line’s site, linked from this page; ask the author before you reprint it or build it into software. Anyone on the care team can hand it out, and a clinician reads the result. The recording template on this page is free to copy or download.
Nine questions on the last two weeks: depression screening and severity, scored 0 to 27.
Two questions on interest and mood: a quick first screen for depression, scored 0 to 6.
Seven questions on worry and tension: anxiety screening and severity, scored 0 to 21.
Up to six questions on suicidal thoughts and behavior; the highest yes sets low, moderate, or high risk.
Twenty items on the past month: PTSD screening and symptom tracking, scored 0 to 80.
Where to find the form, what each validation study measured, and how to correct a mis-scored or incomplete record.
The full assessment a positive screen leads to: episode history, mental status, risk, and diagnosis.
How severe mania is now, once bipolar disorder is known: 11 items, scored 0 to 60.
Every tool, by area, with what its scores mean.
Vero records scores, findings, and plans in the templates you choose, so you review instead of type.
No credit card required. 10 free actions every month.