Psychiatry Department, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
BMC Psychiatry. 2012 Jan 31;12:8. doi: 10.1186/1471-244X-12-8.
The Mood Disorder Questionnaire (MDQ) is a well-recognized screening tool for bipolar disorder, but its Chinese version needs further validation. This study aims to measure the accuracy of the Chinese version of the MDQ as a screening instrument for bipolar disorder (BPD) in a group of patients with a current major depressive episode.
142 consecutive patients with an initial DSM-IV-TR diagnosis of a major depressive episode were screened for BPD using the Chinese translation of the MDQ and followed up for one year. The final diagnosis, determined by a special committee consisting of three trained senior psychiatrists, was used as a 'gold standard' and ROC was plotted to evaluate the performance of the MDQ. The optimal cut-off was chosen by maximizing the Younden's index.
Of the 142 patients, 122 (85.9%) finished the one year follow-up. On the basis of a semi-structured clinical interview 48.4% (59/122) received a diagnosis of unipolar depression (UPD), 36.9% (45/122) BPDII and 14.8% (18/122) BPDI. At the end of the one year follow-up,9 moved from UPD to BPD, 2 from BPDII to UPD, 1 from BPDII to BPDI, the overall rate of initial misdiagnosis was 16.4%. MDQ showed a good accuracy for BPD: the optimal cut-off was 4, with a sensitivity of 0.72 and a specificity of 0.73. When BPDII and BPDI were calculated independently, the optimal cut-off for BPDII was 4, with a sensitivity of 0.70 and a specificity of 0.73; while the optimal cut-off for BPDI was 5, with a sensitivity of 0.67 and a specificity of 0.86.
Our results show that the Chinese version of MDQ is a valid tool for screening BPD in a group of patients with current depressive episode on the Chinese mainland.
心境障碍问卷（MDQ）是一种公认的双相障碍筛查工具，但需要进一步验证其中文版。本研究旨在评估中文版 MDQ 作为当前重性抑郁发作患者双相障碍（BPD）筛查工具的准确性。
142 例符合 DSM-IV-TR 重性抑郁发作诊断的患者，采用 MDQ 中文版进行 BPD 筛查，并进行为期 1 年的随访。最终诊断由 3 名资深精神病学家组成的专门委员会确定，并作为“金标准”，采用 ROC 曲线评估 MDQ 的表现。选择最优截断值以最大化 Youden 指数。
142 例患者中，122 例（85.9%）完成了 1 年随访。基于半定式临床访谈，48.4%（59/122）诊断为单相抑郁（UPD），36.9%（45/122）为双相障碍 2 型（BPDII），14.8%（18/122）为双相障碍 1 型（BPDI）。在 1 年随访结束时，9 例从 UPD 转为 BPD，2 例从 BPDII 转为 UPD，1 例从 BPDII 转为 BPDI，初始误诊率为 16.4%。MDQ 对 BPD 具有较好的准确性：最优截断值为 4，敏感度为 0.72，特异度为 0.73。当分别计算 BPDII 和 BPDI 时，BPDII 的最优截断值为 4，敏感度为 0.70，特异度为 0.73；BPDI 的最优截断值为 5，敏感度为 0.67，特异度为 0.86。
我们的研究结果表明，中文版 MDQ 是中国大陆当前重性抑郁发作患者筛查 BPD 的有效工具。
