Scoring the MDQ

Table of Contents

Scoring the Mood Disorders Questionnaire

The following scores are the most indicative of having bipolar disorder, though be careful: a positive test does not mean you have bipolar disorder (read on to understand that). The authors found these scores include the most individuals who do have bipolar disorder, and “rule out” the most individuals who don’t have it.

Section 1 7 yes responses
Section 2 Yes
Section 3 Yes/ must cause some problems in life

Don’t go away yet, though. How do you know whether the test was “right”? All tests like this have a built-in rate of being wrong. If you’ll stick with me, I think I can help you understand more about this.

Think about it: they had to have a way of saying who definitely “has” bipolar disorder, as a way of “testing the test”. If the test says yes, but their “gold standard”, their definite authority — whatever that was — says no, then that means the test is not working perfectly. They tried using 6 yes’s, and 8 yes’s. But the test performed best, compared to their experts’ gold standard, when 7 was used as the official “cut-off”.

You need to know this. When somebody offers you a “test”, which says whether you have some diagnosis or not, this is how it is done. The test is compared to some “gold standard” way of knowing.

You see the problem? In bipolar disorder, we have no gold standard way of knowing! There is no “lab test” that measures some chemical only bipolar people have. (Hopefully in the next 5 years or so we’ll have something like that). The “gold standard” used in testing the test you just took was some experts using a list of diagnostic criteria, and talking with the patient for an hour. Not a really great standard, but the best we now have.

What’s the point of all this? You just took a test, and the scoring system says: seven items = “yes”, and less than that = “no”. Just be careful and understand: the test you took is not magic. Even using “7 yes’s” as the cut-off, one person in 10 will be missed that their gold standard thought “had bipolar disorder”. Similarly, getting 7 yes answers doesn’t prove you have bipolar disorder, because there can be “false positives” too, with this or any such test how many false positives? that gets pretty complicated. If you really want to know, try this.

When you put all this together, I hope you can see that taking a test like this doesn’t offer “the answer”. It is a shorthand version of deciding something that would otherwise take you hours to learn about, e.g. by reading all the material on this site about diagnosis and diagnosis details. You would be well served to do just that reading, and if you do, I hope you will then have a better understanding of whether you might “have” bipolar disorder than a single test result can provide.  If after all that you still want it, there’s are two better screening tools: the Bipolar Spectrum Diagnostic Scale (because mood is a spectrum thing) and the HCL-32.

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