To assess the sensitivity and specificity of a self-report questionnaire for bipolar disorder, the Bipolar Spectrum Diagnostic Scale (BSDS).
The BSDS was administered to 68 consecutive patients with bipolar illness and 27 consecutive patients with unipolar major depressive disorder. Created by Ronald Pies, it consists of a descriptive story that captures subtle features of bipolar illness, to which patients may assent on a sentence-by-sentence basis. BSDS scores were compared to clinicians' DSM-IV-based diagnoses.
Sensitivity of the BSDS was 0.76, approximately equal in bipolar I and II/NOS subjects (0.75 and 0.79, respectively). The BSDS identified 85% of unipolar-depressed patients as not having bipolar spectrum illness. A shift in the threshold of the BSDS resulted in a large increase in specificity (from 0.85 to 0.93), without a significant loss of sensitivity.
The BSDS was highly sensitive and specific for bipolar spectrum illness, especially with the amended threshold for positive diagnosis.
"The Persian version of Mood Disorder Questionnaire (P-MDQ) (Das et al., 2005) and the Persian and validated version of Bipolar Spectrum Diagnostic Scale (P-BSDS) were exploited to screen bipolar spectrum disorders (Shabani et al., 2009). The psychometric properties of the Persian version have also been assessed in previous studies (Nassir Ghaemi et al., 2005). Out of 658 students, 58 refused to participate in the study and 6 students withdrew the interview. "
"Although it does not discriminate between different subtypes of BD, HCL-32 seems to be more sensitive towards BD II  . Moreover, the Bipolar Spectrum Diagnostic Scale (BSDS), a one-page story describing typical mood swing experiences, has sensitivity (73%) and specificity (90%) in psychiatric adult outpatients equivalent to those of the MDQ . It was recently reported to be more sensitive for BD II and BD NOS than the MDQ . "
[Show abstract][Hide abstract] ABSTRACT: This study assessed the psychometric performance of the Mood Disorder Questionnaire (MDQ) and its modified MDQ7 version, to screen for bipolar disorders (BD) in depressive inpatients according to depression severity, number of current axis I psychiatric comorbidities and suicidal behavior disorders.
Depressed adult inpatients (n=195) were consecutively enrolled. Psychiatric diagnoses were made using the standardized DSM-IV-TR structured interview MINI 5.0.0 and medical case notes. Depression severity was assessed with the Beck Depression Inventory and the Hamilton Depression Scale. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each MDQ version were evaluated in the whole sample and according to depression severity, current axis I psychiatric comorbidities and suicidal behavior.
The occurrence and the number of axis I disorders affected performance of both versions. Among depressed patients with two or more comorbidities, PPV and NPV of the MDQ were 65% and 80%, respectively, and they were respectively 56.2% and 87.9% with MDQ7. Current suicidal behavior disorders also dramatically reduced the PPV of MDQ (from 81.2% to 63.3%) and MDQ7 (from 72.2% to 52.6%) but the NPV remained above 80%. The performance of both versions of the MDQ tended to improve with the severity of depression.
The MDQ is not a suitable screening instrument to diagnose BD in subjects with a complex major depressive episode and/or a current history of suicidal behavior. Nevertheless MDQ particularly in its modified version may be useful for ruling out the presence of BD among these complex patients.
"these questionnaires (Mood Disorder Questionnaire, MDQ; Hypomania Checklist-32, HCL-32) were designed to screen from a lifetime history of (hypo)manic syndromes (Angst et al., 2005; Hirschfeld et al., 2000), and one (Bipolar Spectrum Diagnostic Scale, BSDS) was designed to assess mood fluctuations, such as high or low mood, and to detect the milder portions of the bipolar spectrum (Ghaemi et al., 2005). The application of these questionnaires not only to psychiatric but also to primary care clinics has been tested previously (Hirschfeld et al., 2005; Smith et al., 2011). "
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: We developed a self-reported questionnaire, the Manic Episode Screening Questionnaire (MES), based on the eight diagnostic criteria items of DSM-IV-TR (hypo)manic episodes. This study was designed to determine the optimal screening methods to identify bipolar disorders among mood disorder patients of a psychiatric specialty clinic. METHODS: In 95 mood disorder patients, we assessed the operational characteristics of the MES as a screening and diagnostic instrument using a DSM-IV-TR diagnosis by a trained psychiatrist as a reference standard. The reference criteria were bipolar disorders. MES was used with two methods: the diagnostic algorithm and the one-question method (question #1 only). The diagnostic algorithm was regarded as fulfilled if the answers to question #1 and three or more of questions #2 to #8 were "yes", corresponding to the DSM-IV-TR (hypo)manic episode criteria. In different subjects, the test-retest reliability of the MES was examined. RESULTS: The two methods of the MES showed high specificity (0.93-0.94), high positive predictive value (0.81-0.83) and high negative predictive value (0.88-0.90), but the sensitivity scored lower (0.68-0.75). The test-retest reliability was moderate: 0.75 for the diagnostic algorithm and 0.68 for the one-question method. LIMITATIONS: This study includes a small number of bipolar I patients. The findings might not be generalized to patients outside of this patient population. CONCLUSIONS: The MES is useful for the screening and diagnosis of bipolar disorders among mood disorder patients in psychiatric specialty clinics. The one-question method of the MES is more convenient to use than prior questionnaires and is here recommended.
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