Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, China.
J Affect Disord. 2012 Dec 1;141(1):40-6. doi: 10.1016/j.jad.2012.02.035. Epub 2012 Mar 19.
Bipolar disorder (BD) is often misdiagnosed as a major depressive disorder (MDD). This study aimed to test the usefulness of the screening tool, the Mood Disorders Questionnaire (MDQ), to identify BD patients misdiagnosed as MDD in Chinese clinical settings.
A total of 1487 patients treated for MDD were consecutively examined in 13 mental health centers in China. The patients' socio-demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. The MDQ was completed by patients to identify symptoms characteristic of BD. DSM-IV diagnoses were established using the Mini International Neuropsychiatric Interview (MINI).
Three hundred-nine of the 1487 patients (20.8%) satisfied DSM-IV criteria for BD; 118 (7.9%) for BD-I and 191 (12.8%) for BD-II on the MINI. The optimal cut-off point on the MDQ to differentiate BD from MDD was 3, while cut-off points of 5 and 3 differentiated BD-I and BD-II from MDD, respectively. The maximum sensitivity was 0.31, 0.45 and 0.22 for differentiating BD, BD-I and BD-II from MDD, respectively.
The optimal cutoff points of the MDQ for screening BD in Chinese patients originally diagnosed as MDD were considerably lower than those in earlier studies. The routine clinical use of the MDQ as a screening scale for BD in Chinese patients treated for MDD does not seem to be justified.
双相情感障碍（BD）常被误诊为重度抑郁症（MDD）。本研究旨在检验心境障碍问卷（MDQ）作为一种筛查工具，用于识别中国临床环境中被误诊为 MDD 的 BD 患者的有效性。
本研究共纳入了 13 家精神卫生中心连续收治的 1487 例 MDD 患者。使用标准化的协议和数据收集程序记录患者的社会人口学和临床特征。患者填写 MDQ 以识别 BD 的特征性症状。使用迷你国际神经精神访谈（MINI）建立 DSM-IV 诊断。
1487 例患者中，309 例（20.8%）符合 DSM-IV 双相情感障碍标准；MINI 诊断为 118 例（7.9%）为双相情感障碍 I 型，191 例（12.8%）为双相情感障碍 II 型。MDQ 区分 BD 和 MDD 的最佳截断点为 3，而 5 和 3 的截断点分别区分 BD-I 和 BD-II 与 MDD。区分 BD、BD-I 和 BD-II 与 MDD 的最大灵敏度分别为 0.31、0.45 和 0.22。
最初诊断为 MDD 的中国患者中，MDQ 筛查 BD 的最佳截断点明显低于早期研究中的值。因此，将 MDQ 常规用于中国 MDD 患者的 BD 筛查似乎并不合理。
