The Mood Disorder Questionnaire (MDQ) for detecting (hypo)manic episodes: its validity and impact of recall bias

Lynn Boschloo, Willem A Nolen, Annet T Spijker, Erik Hoencamp, Ralph Kupka, Brenda W J H Penninx, Robert A Schoevers

    Research output: Contribution to JournalArticleAcademicpeer-review

    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.

    LIMITATIONS: 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.

    Original languageEnglish
    Pages (from-to)203-208
    Number of pages6
    JournalJournal of Affective Disorders
    Volume151
    Issue number1
    Early online date19 Jun 2013
    DOIs
    Publication statusPublished - Oct 2013

    Fingerprint

    Mood Disorders
    Bipolar Disorder
    Surveys and Questionnaires
    Diagnostic and Statistical Manual of Mental Disorders
    Cluster Analysis
    Sensitivity and Specificity

    Keywords

    • Adult
    • Bias
    • Bipolar Disorder/diagnosis
    • Female
    • Humans
    • Male
    • Mental Recall
    • Psychiatric Status Rating Scales/standards
    • Reproducibility of Results
    • Sensitivity and Specificity
    • Surveys and Questionnaires

    Cite this

    Boschloo, Lynn ; Nolen, Willem A ; Spijker, Annet T ; Hoencamp, Erik ; Kupka, Ralph ; Penninx, Brenda W J H ; Schoevers, Robert A. / The Mood Disorder Questionnaire (MDQ) for detecting (hypo)manic episodes : its validity and impact of recall bias. In: Journal of Affective Disorders. 2013 ; Vol. 151, No. 1. pp. 203-208.
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    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.LIMITATIONS: 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.",
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    author = "Lynn Boschloo and Nolen, {Willem A} and Spijker, {Annet T} and Erik Hoencamp and Ralph Kupka and Penninx, {Brenda W J H} and Schoevers, {Robert A}",
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    The Mood Disorder Questionnaire (MDQ) for detecting (hypo)manic episodes : its validity and impact of recall bias. / Boschloo, Lynn; Nolen, Willem A; Spijker, Annet T; Hoencamp, Erik; Kupka, Ralph; Penninx, Brenda W J H; Schoevers, Robert A.

    In: Journal of Affective Disorders, Vol. 151, No. 1, 10.2013, p. 203-208.

    Research output: Contribution to JournalArticleAcademicpeer-review

    TY - JOUR

    T1 - The Mood Disorder Questionnaire (MDQ) for detecting (hypo)manic episodes

    T2 - its validity and impact of recall bias

    AU - Boschloo, Lynn

    AU - Nolen, Willem A

    AU - Spijker, Annet T

    AU - Hoencamp, Erik

    AU - Kupka, Ralph

    AU - Penninx, Brenda W J H

    AU - Schoevers, Robert A

    N1 - © 2013 Elsevier B.V. All rights reserved.

    PY - 2013/10

    Y1 - 2013/10

    N2 - 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.LIMITATIONS: 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.

    AB - 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.LIMITATIONS: 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.

    KW - Adult

    KW - Bias

    KW - Bipolar Disorder/diagnosis

    KW - Female

    KW - Humans

    KW - Male

    KW - Mental Recall

    KW - Psychiatric Status Rating Scales/standards

    KW - Reproducibility of Results

    KW - Sensitivity and Specificity

    KW - Surveys and Questionnaires

    U2 - 10.1016/j.jad.2013.05.078

    DO - 10.1016/j.jad.2013.05.078

    M3 - Article

    VL - 151

    SP - 203

    EP - 208

    JO - Journal of Affective Disorders

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    SN - 0165-0327

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