Kemp David E, Hirschfeld Robert M A, Ganocy Stephen J, Elhaj Omar, Slembarski Renee, Bilali Sarah, Conroy Carla, Pontau James, Findling Robert L, Calabrese Joseph R
Department of Psychiatry, Case Western Reserve University, Cleveland, OH 44106, USA.
J Psychiatr Res. 2008 Jul;42(9):778-86. doi: 10.1016/j.jpsychires.2007.08.001. Epub 2007 Nov 1.
This study assessed the operating characteristics of the mood disorder questionnaire (MDQ) among offenders arrested and detained at a county jail.
The MDQ, a brief self-report instrument designed to screen for all subtypes of bipolar disorder (BP I, II and NOS) was voluntarily administered to adult detainees at the Ottawa County Jail in Port Clinton, Ohio. A confirmatory diagnostic evaluation was also performed using the mini-international neuropsychiatric interview (MINI). The MDQ was scored using a standard algorithm requiring endorsement of 7/13 mood items as well as two items that assess whether manic or hypomanic symptoms co-occur and cause moderate to severe functional impairment. In addition to the standard algorithm for scoring the MDQ, modifications were also tested in an attempt to improve overall sensitivity.
Among 526 jail detainees who completed the MDQ, 37 (7%) screened positive for bipolar disorder. Of 164 detainees who agreed to a research diagnostic evaluation, 32 (19.5%) screened positive on the MDQ, while 55 (33.5%) met criteria for bipolar disorder according to the MINI. When administered to the sample of 164 adult jail detainees, the sensitivity of the MDQ was 0.47 and the specificity was 0.94. The MDQ was significantly better at detecting BP I (0.59) than BP II/NOS (0.19; p=0.008). Modification of scoring the MDQ improved the sensitivity for detection of BP II from 0.23 to 0.54 with minimal decrease in specificity (0.84). The optimum sensitivity and specificity of the MDQ was achieved by decreasing the item threshold to 3/13 and eliminating the symptom co-occurrence and functional impairment items.
The MDQ was found to have limited utility as a screening tool for bipolar disorder in a correctional setting, particularly for the BP II subtype.
本研究评估了情绪障碍问卷（MDQ）在某县监狱被逮捕和拘留的罪犯中的应用特点。
MDQ是一种用于筛查双相情感障碍所有亚型（I型、II型和未特定型）的简短自评工具，在俄亥俄州克林顿港渥太华县监狱，对成年被拘留者进行了自愿施测。同时使用迷你国际神经精神访谈（MINI）进行了确诊性诊断评估。MDQ采用标准算法计分，要求认可13项情绪条目中的7项，以及两项评估躁狂或轻躁狂症状是否同时出现并导致中度至重度功能损害的条目。除了MDQ的标准计分算法外，还测试了一些修改方法，以试图提高总体敏感性。
在526名完成MDQ的监狱被拘留者中，37人（7%）双相情感障碍筛查呈阳性。在164名同意进行研究诊断评估的被拘留者中，32人（19.5%）MDQ筛查呈阳性，而根据MINI，55人（33.5%）符合双相情感障碍标准。在164名成年监狱被拘留者样本中施测时，MDQ的敏感性为0.47，特异性为0.94。MDQ在检测双相I型（0.59）方面明显优于双相II型/未特定型（0.19；p=0.008）。MDQ计分的修改将双相II型的检测敏感性从0.23提高到0.54，而特异性仅有轻微下降（0.84）。通过将条目阈值降至3/13并去除症状共现和功能损害条目，实现了MDQ的最佳敏感性和特异性。
研究发现，在惩教环境中，MDQ作为双相情感障碍的筛查工具效用有限。
