Cyprien Fabienne, Guillaume Sébastien, Jaussent Isabelle, Lopez-Castroman Jorge, Mercier Grégoire, Olie Emilie, Courtet Philippe
Psychiatric Department, CHU Nîmes, Hopital Carémeau, Nîmes, France; Inserm U1061 Montpellier, France; University of Montpellier 1, Montpellier, France.
Inserm U1061 Montpellier, France; Psychiatric Emergency and Post Emergency Department, CHU Montpellier, Hôpital Lapeyronie, Pole Urgence, Montpellier, France; University of Montpellier 1, Montpellier, France.
Compr Psychiatry. 2014 May;55(4):876-82. doi: 10.1016/j.comppsych.2014.02.004. Epub 2014 Feb 13.
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.
本研究评估了心境障碍问卷（MDQ）及其修订版MDQ7的心理测量性能，以根据抑郁严重程度、当前轴I精神共病数量和自杀行为障碍，对抑郁住院患者中的双相情感障碍（BD）进行筛查。
连续纳入成年抑郁住院患者（n = 195）。使用标准化的DSM-IV-TR结构化访谈MINI 5.0.0和病历进行精神科诊断。用贝克抑郁量表和汉密尔顿抑郁量表评估抑郁严重程度。在整个样本中，并根据抑郁严重程度、当前轴I精神共病和自杀行为，评估每个MDQ版本的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
轴I障碍的发生情况和数量影响了两个版本的性能。在有两种或更多共病的抑郁患者中，MDQ的PPV和NPV分别为65%和80%，MDQ7的PPV和NPV分别为56.2%和87.9%。当前的自杀行为障碍也显著降低了MDQ（从81.2%降至63.3%）和MDQ7（从72.2%降至52.6%）的PPV，但NPV仍高于80%。两个版本的MDQ性能都倾向于随着抑郁严重程度的增加而提高。
MDQ不是诊断复杂重度抑郁发作和/或有自杀行为史患者中BD的合适筛查工具。然而，MDQ尤其是其修订版可能有助于排除这些复杂患者中BD的存在。
