Mood Disorder Questionnaire

Issue the Mood Disorder Questionnaire for mood disorders to gauge your patients' symptoms during the screening process.

By Matt Olivares on Jun 20, 2024.

Fact Checked by Ericka Pingol.

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Mood Disorder Questionnaire PDF Example
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What is this Mood Disorder Questionnaire (MDQ)?

Mood disorders are a type of mental health condition that significantly impact the emotional states and overall mood of those with it. Depending on their severity, mood disorders can also negatively affect other aspects of a person’s life, including their relationships and daily activities.

Bipolar Disorder is an example of a mood disorder. This is characterized by sudden and intense mood swings, referred to as“episodes. There are two types of Bipolar Disorder episodes: manic and depressive.

When an individual experiences a manic episode, they exhibit heightened energy levels and a strong desire to engage in various activities. This state can be accompanied by irritability. Conversely, during a depressive episode, a person tends to feel sad and low. They may experience emotions of worthlessness, emptiness, and, in severe cases, despair. They may also become indifferent towards most if not all, things. It is also possible for some individuals to experience both episodes simultaneously.

To diagnose a person with a mood disorder, healthcare professionals must conduct interviews and comprehensive tests. These tests often include the use of assessments. One assessment that can be used is the Mood Disorder Questionnaire, a five-item questionnaire developed to help accurately diagnose people with Bipolar Disorder.

Printable Mood Disorder Questionnaire (MDQ)

Download this Mood Disorder Questionnaire (MDQ) to assess clients effectively.

How to use the Mood Disorder Questionnaire:

The Mood Disorder Questionnaire is a relatively straightforward questionnaire consisting of five items. However, it's worth noting that the first item encompasses multiple sub-items, which participants must respond to to complete the questionnaire. Therefore, while we refer to it as a five-item questionnaire, it actually contains additional components within the first item.

There are two approaches to administering the Mood Disorder Questionnaire:

  1. The first method involves conducting it as an interview, where each item (including sub-items for the first one) is presented to the patient, and they provide their responses. This approach may take longer, but it allows patients to delve deeper into their answers. It's worth noting that the additional information gathered during this process can be valuable when conducting further tests and compiling results.
  1. The second approach is to provide the questionnaire to the patient and allow them to answer it independently. If they take it home, it's important to establish a mutual agreement on when you should receive a completed copy, enabling you to proceed with the remaining screening as soon as possible.

Either way, they just need to answer the following items:

  1. Has there ever been a period when you were not your usual self and...
  • This part has numerous statements that complete the sentence above. Please check the template sample later to see the sub-items.
  1. If you checked YES to more than one of the above, have several of these ever happened during the same period?
  1. 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?
  1. Have any of your blood relatives (i.e., children, siblings, parents, grandparents, aunts, uncles) had manic-depressive illness or bipolar disorder?
  1. Has a health professional ever told you that you have manic-depressive illness or bipolar disorder?

The patient just needs to answer YES or NO for all items except for Item 3. For Item 3, they need to select one from the following:

  • No Problem
  • Minor Problem
  • Moderate Problem
  • Serious Problem

After receiving a fully-accomplished copy of the Mood Disorder Questionnaire, check all their answers for the following:

  • If they answered YES to at least seven sub-items under Item 1;
  • If they answered YES for Item 2;
  • And if they answered Moderate Problem or Serious Problem for Item 3.

If they meet the above criteria, they are positive for this screening. After this, you need to conduct a comprehensive examination for Bipolar Disorder.

Mood Disorder Questionnaire Example

We adapted the original version created by Hirschfeld R, Williams J, Spitzer RL, et al. to create a sample.  We simply added radio buttons for patients or clinicians to tick. We also included an additional comments box, so you can write your observations in the form.

If you like what you see and believe this will help you better gauge patients who potentially have Bipolar Disorder, by all means, please download our free Mood Disorder Questionnaire PDF template.

Download this Mood Disorder Questionnaire (MDQ) Example:

Mood Disorder Questionnaire Example

When is it best to use the Mood Disorder Questionnaire?

A team of experts developed The Mood Disorder Questionnaire to prompt and accurate diagnosis and provide appropriate treatment for individuals suspected of having Bipolar Disorder. You can utilize this template as soon as a patient presents for a scheduled appointment, particularly if they are being evaluated for Bipolar Disorder. Additionally, the questionnaire can be employed during sessions when the patient mentions symptoms or experiences that could potentially indicate the presence of Bipolar Disorder.

Note that the Mood Disorder Questionnaire serves as a screening rather than a diagnostic tool. It aims to aid in the diagnostic process by providing valuable information that can be utilized later on. Once you receive a completed copy and your patient meets the criteria for a positive screening result, referring them for other comprehensive examinations is crucial. This is necessary to gather sufficient information before an official diagnosis.

What are the benefits of the Mood Disorder Questionnaire?

It is free and easy to use

The Mood Disorder Questionnaire is a cost-effective clinical tool that can be easily utilized by printing out a copy or using a digital PDF version. This assessment does not require any specialized equipment or additional tests. Moreover, due to its concise nature, patients can complete the questionnaire in approximately five minutes. Once the questionnaire is completed, you can promptly proceed with the remaining components of the diagnostic process for Bipolar Disorder.

It helps in early detection

As previously mentioned, experts' purpose behind developing the Mood Disorder Questionnaire was to facilitate the prompt and accurate diagnosis of Bipolar Disorder in patients. One of the driving factors behind its creation was the alarming statistic that approximately 70% of individuals with Bipolar Disorder had experienced at least one misdiagnosis in the past. 

Furthermore, many of them had to endure a waiting period of nearly a decade before receiving an official and correct diagnosis. However, with the introduction of this tool, the likelihood of detecting early signs of Bipolar Disorder has significantly increased. This enables the screening of patients at the earliest possible stage, leading to prompt and accurate diagnoses and ensuring that they receive the necessary treatment to manage their symptoms before they worsen effectively.

It can be used to educate patients

The Mood Disorder Questionnaire relies on patients actively engaging with it to provide their answers. This tool empowers patients to play a significant role in their own mood disorder assessment, allowing them time to contemplate and reflect upon their symptoms. It also allows them to expand upon their feelings and experiences. Professionals administering the questionnaire can seize this opportunity to educate patients about the tool itself and Bipolar Disorder in general.

How can Carepatron help with mental health-related work?

If you are a therapist, psychologist, psychiatrist, or an adjacent mental healthcare professional, you’ll feel right at home with us at Carepatron! Besides this guide about the Mood Disorder Questionnaire and our free PDF template for it, we have a lot more in store for you.

One of the features that we’re most proud of is our resource library, which is filled to the brim with clinical resources. This collection spans numerous healthcare fields, especially mental health. There are worksheets that you can use to get to know your patients in terms of what they’re dealing with (and to see if they can properly apply what you’ve taught them), assessments that can be used to gauge patients and their symptoms of mental health problems (just like the Mood Disorder Questionnaire), survey templates, progress note templates, form templates, and much more. They’re all for free, too, so download as much as you want and need!

We also have a storage system that you can use when you subscribe to us! This nifty system will allow you to store your clinical files with us in a HIPAA-compliant manner, which means that only you can dictate who can access them. Even we can’t access them! We’re fully committed to following HIPAA mandates, that’s why only you can grant access permissions to your files. You can even store filled-out copies of the Mood Disorder Questionnaire with us if you wish.

Storing your files with us is a good way to create backups, so just in case you lose your physical copies, lose access to another cloud storage, or your current work device stops working, you can rest easy knowing that you can simply re-download your files from your storage under us.

Not only will Carepatron provide you with resources to help you cover more ground with your therapeutic work, but we can also help preserve your work by securing them!

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How long does it take to accomplish the Mood Disorder Questionnaire?
How long does it take to accomplish the Mood Disorder Questionnaire?

Commonly asked questions

How long does it take to accomplish the Mood Disorder Questionnaire?

Patients can accomplish the questionnaire within five minutes.

Are clinicians only allowed to use this? What if I’m not a professional and I stumbled upon this? May I use the Mood Disorder Questionnaire to assess myself?

Yes. The Mood Disorder Questionnaire can be used as a self-report assessment. If you get a positive screening based on the criteria, please see a professional for further evaluation. Under no circumstance should you diagnose yourself if you get a positive screening result.

Is the Mood Disorder Questionnaire a diagnostic tool?

No. It is a screening tool that’s used early in the diagnostic process. A diagnosis should only be made after conducting a further examination/evaluation of a patient.

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