Mood disorders questionaire
For detailed instructions click here.
Name
Date of birth



Has there ever been a time when you were not your usual self and . . .
Yes
No
you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble?
 
you were so irritable that you shouted at people or started fights or arguments?
you felt much more self-confident than usual?
you got much less sleep than usual and found that you didn't really miss it?
you were more talkative or spoke much faster than usual?
thoughts raced through your head or you couldn't slow your mind down?
you were so easily distracted by things around you that you had trouble concentrating or staying on track?
you had much more energy than usual?
you were much more active or did many more things than usual?
you were much more social or outgoing than usual, for example you telephoned friends in the middle of the night?
you were much more interested in sex than usual?
you did things that were unusual for you or that other people might have thought were excessive, foolish or risky?
spending money got you or your family into trouble?
If you checked YES to more than one of the above, have several of these ever happened during the same period of time?
How much of a problem did any of these cause you - like being able to work; having family, money or legal troubles: getting into arguments or fights?
No problem
Minor problem Moderate problem
Serious problem
Have any of your blood relatives [ie children, siblings, parents, grandparents, aunts, uncles] had manic-depressive illness or bipolar disorder?
Has a health professional ever told you that you have manic-depressive illness or bipolar disorder?



This instrument is designed for screening purposes only and is not to be used as a diagnostic tool.  Go here for scoring instructions.
Derived from:  Hirschfeld RM.  Am. J. Psychiatry 2000: 157(11) 1873-1875
For detailed analysis of MDQ go to this link.