User:Hjlucero/MDQ

Google Drive
Here is the link to the MDQ google drive. Please put your articles and sources here.

Introduction
The Mood Disorder Questionnaire (MDQ) is a 15-item self-report questionnaire designed to help detect bipolar disorder. It focuses on symptoms of hypomania and mania, which are the mood states that separate bipolar disorders from other types of depression and mood disorder. The MDQ was originally tested with adults, but it also has been studied in adolescents ages 11 years and above. It takes approximately 5–10 minutes to complete. In 2006, a parent-report version was created to allow for assessment of bipolar symptoms in children or adolescents from a caregiver perspective, with the research looking at youths as young as 5 years old. The MDQ has become one of the most widely studied and used questionnaires for bipolar disorder, and it has been translated into more than a dozen languages.
 * What are the acronyms? What do they stand for?
 * What is the purpose of the measure?
 * What is the intended population of the measure?
 * How long does it take to take/administer the assessment?
 * Who wrote the measure?
 * It was created and validated by Robert Hirschfeld, MD, and colleagues.
 * Colleagues = Hirschfeld RM, Williams JB, Spitzer RL, et al
 * How many items does the measure contain?
 * The MDQ has 15 questions. The first 13 questions about possible symptoms are answered using "yes" or "no".
 * What kind of impact did the measure have?
 * Ex: is it more sensitive than existing measures?
 * What kinds of settings is the measure most typically used?
 * Ex: research, clinical

Versions
In 2006, a 3-item parent-report version was created to allow for assessment of adolescent bipolar symptoms from a caregiver perspective. The MDQ has been translated for use in other countries; there is a Polish version, a Thai version, a Chinese version, a Brazilian version, a French version.

It is recommended that clinicians show discretion when administering the MDQ with individuals with substance use problems because the effects of certain substances, such as stimulants, can cause effects that resemble symptoms of mania.
 * How many versions of the measure are there?
 * What is the intended population for each version?
 * How many items are in each version of the measure?
 * The polish version has 17 items in the MDQ.
 * What are the acronyms for each version?

Reliability
Reliability refers to whether the scores are reproducible. Unless otherwise specified, the reliability scores and values come from studies done with a United States population sample. Here is the rubric for evaluating the reliability of scores on a measure for the purpose of evidence based assessment.


 * What were the norms from the measure’s first publication?
 * IE what was the demographics of the population used to first validate this measure?
 * What is the internal consistency?
 * Internal consistency: how well the items relate/correlate to one another
 * Normally reported as an alpha or Cronbach's alpha
 * What is the inter-rater reliability?
 * Inter-rater reliability: how consistently the measure gives the same results across different raters (*not applicable for self-report*)
 * Normally reported as kappa
 * What is the test-retest reliability?
 * Test-retest: how consistently the measure gives the same result after the same person takes the test multiple times

Validity
Validity describes the evidence that an assessment tool measures what it was supposed to measure. There are many different ways of checking validity. For screening measures, diagnostic accuracy and discriminative validity are probably the most useful ways of looking at validity. Unless otherwise specified, the validity scores and values come from studies done with a United States population sample. Here is a rubric for describing validity of test scores in the context of evidence-based assessment.


 * What is the content validity?
 * Content validity: how much the items relate to what you are trying to measure
 * What is the construct validity?
 * Construct validity: how well the assessment is able to measure the abstract concept  it is trying to measure
 * Ex: An ADHD assessment with good construct validity correlates very highly with ADHD diagnoses
 * What is the discriminative validity?
 * Discriminative validity: how well the measure does NOT measure what it is NOT supposed to measure
 * Ex: An ADHD assessment with high discriminative validity would not measure severity of schizophrenic symptoms
 * What is the prescriptive validity?
 * Prescriptive validity: Refers to the capacity of an assessment to inform which intervention will have the best outcomes for a client
 * What is the validity generalization?
 * Validity generalization: how well the validity of the measure holds true across different populations
 * Ex: a measure that has been validated in multiple languages and has high validity with college students, as a self-report, and as a caregiver report would have good validity generalization
 * Is the measure sensitive to treatment? How sensitive?
 * IE: can you use this measure throughout the course of a treatment to see if the treatment is working?
 * What is the clinical utility of the measure?
 * IE: does this measure ultimately help clinicians and clients?
 * Ex: if the measure costs a lot of money to take, is long, cumbersome, and has low validity/reliability, then it would have low clinical utility

Development and history
The MDQ was developed as a screening tool for bipolar disorder, and assesses symptoms of mania and hypomania It was developed in the hopes that it would reduce the misdiagnosis and delayed diagnosis of bipolar disorder. The first 13 items on the measure ask about any manic/hypomanic symptoms that may have occurred during one’s lifetime. These items are based on the DSM-IV criteria for bipolar disorder. Additional items then ask if these symptoms have happened during the same period of time (an "episode"), and how severely these symptoms affected functioning (assessing impairment). In developing this tool, the MDQ was administered to a group of bipolar patients to assess feasibility and face validity, leading to revision of the items. Following this initial study, researchers have assessed psychometric properties of the MDQ, finding that the measure possesses adequate internal consistency. The measure has also demonstrated fair sensitivity in several studies, although sensitivity may be greater in inpatient versus community settings. First built for use in adults, it has been translated into many languages and tested in a range of different settings. Researchers also have studied whether parents could use this to provide useful information about their child or adolescent. Meta-analyses have found that the MDQ is one of the best self-report tools for assessing hypomania or mania in adults, and the parent report version is one of the three best options available for parents to use about their children.
 * Why was the instrument developed? What need did this instrument meet? When?
 * How was the scale developed? What was the theoretical background behind it?
 * If there were previous versions, when were they published?

Impact

 * What was the impact of this assessment? How did it affect assessment in psychiatry, psychology and health care professionals?
 * What can the assessment be used for in clinical settings? Can it be used to measure symptoms longitudinally? Developmentally?

In clinical settings, the MDQ has good reliability and validity for the identification of bipolar disorder I in UK patients enrolled in a tertiary clinic. Research indicates that MDQ might be helpful in identifying bipolar II in UK patients presenting with depressive symptoms, but not manic symptoms.The MDQ is a helpful tool to identify individuals who are at risk for bipolar disorder in Thai clinical settings. In Thai clinical settings, the MDQ is a helpful tool to identify individuals who are at risk for bipolar disorder as well.

Use in other populations

 * How widely has it been used? Has it been translated into different languages? Which languages?

Research

 * Any recent research done that is pertinent?
 * There is recent research done on the reliabilty of the Mood Disorder Questionnaire. The study showed that "the MDQ has substantial limitations for detection of bipolar disorder, in particular, bipolar II disorder, in non-clinical populations."

Limitations
One limitation of the MDQ is that it has shown higher sensitivity when detecting bipolar I compared to other bipolar spectrum disorders. It is much less sensitive to bipolar II, often missing more than half of the cases with this diagnosis when using the recommended algorithm. Additionally, the sensitivity and specificity of the MDQ has been shown to differ by the use of a standard vs. modified cutoff (i.e., simplifies the cutoff to be based only on symptom endorsement, rather than impairment). Sensitivity and specificity of the MDQ also depend on study inclusion and exclusion criteria. Including more severe cases will increase the apparent sensitivity, because it is more likely that they will have high scores. Including healthy controls or people who are not seeking services will exaggerate the specificity of the test, as these individuals are unlikely to have manic symptoms and will score very low on the measure as a result.
 * What are some of the measure’s limitations? Be thorough in your explanation.
 * Ex: does it have low reliability? Is it a self-report measure?
 * Is the measure copyrighted?

Another major limitation of the MDQ is that it is not likely to be sensitive to treatment effects. It asks about lifetime history of symptoms, which is a strength for screening and detection, but a weakness for measuring the current severity of mood symptoms. The MDQ also uses a yes/no format for the symptoms, rather than asking about the severity of each. Other rating scales are more useful for measuring severity and treatment outcomes.

Additionally, self-report measures have some disadvantages, including bias that can stem from social desirability and demand characteristics.

Example page

 * General Behavior Inventory