Mood Disorder Questionnaire Score Interpretation Guide

Once you have counted the boxes on an MDQ, the bigger task is translating that number into action. Use this guide to keep your interpretations consistent across providers.

Classic Positive

Seven or more yes answers, a yes on the clustering question, and moderate or severe impairment equals a positive screen. Move quickly to schedule a diagnostic interview and document the plan in the encounter note.

Borderline Scores

Patients who tally five or six yes answers deserve a second look, especially if they mention sleep loss, family history, or substance use. Consider repeating the MDQ in a few months or adding another tool like the HCL 32 to capture subtler hypomania.

Demographic Considerations

Older adults sometimes underreport symptoms because they attribute them to aging, while adolescents may overreport due to dramatic language. Women and people of color frequently describe irritability instead of euphoria, so probe further when those themes emerge even if the MDQ is technically negative.

When to Rescreen

Anytime a patient’s depression treatment plan stalls, redo the MDQ to check whether mixed features or emerging hypomania could explain the plateau. Consistent interpretation habits make sure no one slips through the cracks because two clinicians read the same score differently.

Trusted Bipolar & MDQ Resources

• Mayo Clinic bipolar diagnosis overview - Walks through the clinical interview, lab work, and differential diagnosis process.
• Depression and Bipolar Support Alliance fact sheet - Peer-led perspective on recognizing mood shifts and supporting self-advocacy.
• Mood Disorder Questionnaire PDF (SAMHSA) - Download the original worksheet behavioral health teams rely on for MDQ screening.
• American Psychiatric Association bipolar overview - Outlines DSM-5 criteria, specifiers, and care pathways from the APA.
• MDCalc Mood Disorder Questionnaire calculator - Interactive calculator that shows how score thresholds flag likely bipolar disorder.