Screening for bipolar disorders in patients with alcohol or substance use disorders: Performance of the Mood Disorder Questionnaire

AbstractBackgroundComorbidity of bipolar disorder and alcohol or substance abuse/dependence is frequent and has marked negative consequences on the course of the illness and treatment compliance. The objective of this study was to compare the validity of two short instruments aimed at screening bipolar disorders among patients treated for substance use disorders.MethodsThe Mood Disorder Questionnaire (MDQ) and the Hypomania Checklist-32 (HCL-32) were tested with reference to the mood section of the Structured Clinical Interview for DSM-IV axis I disorders (SCID) in 152 patients, recruited in two outpatient clinics providing specialized treatment for alcohol and opiate dependence.ResultsAccording to the SCID, 33 patients (21.7%) had a diagnosis within the bipolar spectrum (two bipolar I, 21 bipolar II and 10 bipolar not otherwise specified). The HCL-32 was more sensitive (90.9% vs. 66.7%) and the MDQ more specific (38.7% vs. 77.3%) for the whole sample. The MDQ displayed higher sensitivity and specificity in patients treated for alcohol than for opiate dependence, whereas the HCL-32 was highly sensitive but poorly specific in both samples. Both instruments had a positive predictive value under 50%.ConclusionsCaution is needed when using the MDQ and HCL-32 in patients treated for substance use disorders.

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Substance use disorders in bipolar disorders: Clinical correlates and treatment response to mood stabilizers

Journal of Affective Disorders ◽

10.1016/j.jad.2022.01.001 ◽

2022 ◽

Author(s):

Giulia Menculini ◽

Luca Steardo ◽

Norma Verdolini ◽

Federica Cirimbilli ◽

Patrizia Moretti ◽

...

Keyword(s):

Substance Use ◽

Treatment Response ◽

Substance Use Disorders ◽

Bipolar Disorders ◽

Mood Stabilizers ◽

Clinical Correlates

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Is the Mood Disorder Questionnaire an appropriate screening tool in detecting bipolar spectrum disorder among substance use populations?

The American Journal of Drug and Alcohol Abuse ◽

10.3109/00952990.2010.538944 ◽

2010 ◽

Vol 37 (2) ◽

pp. 79-81 ◽

Cited By ~ 1

Author(s):

Jean-Pierre Chiasson ◽

Élie Rizkallah ◽

Katherine Stavro ◽

Maxime Dussault ◽

Tania Pampoulova ◽

...

Keyword(s):

Substance Use ◽

Mood Disorder ◽

Screening Tool ◽

Spectrum Disorder ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorder ◽

Mood Disorder Questionnaire

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Validity of the Chinese version Mood Disorder Questionnaire (MDQ) and the optimal cutoff screening bipolar disorders

Psychiatry Research ◽

10.1016/j.psychres.2011.02.007 ◽

2011 ◽

Vol 189 (3) ◽

pp. 446-450 ◽

Cited By ~ 23

Author(s):

Hai-chen Yang ◽

Cheng-mei Yuan ◽

Tie-bang Liu ◽

Ling-jiang Li ◽

Hong-jun Peng ◽

...

Keyword(s):

Mood Disorder ◽

Bipolar Disorders ◽

Chinese Version ◽

Optimal Cutoff ◽

Mood Disorder Questionnaire

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Validity of the Mood Disorder Questionnaire in a Brazilian psychiatric population

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462010005000024 ◽

2010 ◽

Vol 32 (4) ◽

pp. 424-428 ◽

Cited By ~ 6

Author(s):

Milena S. Castelo ◽

Eduardo R. Carvalho ◽

Emília S. Gerhard ◽

Carlos Maurício C. Costa ◽

Eduardo D. Ferreira ◽

...

Keyword(s):

Mood Disorder ◽

Predictive Value ◽

Bipolar Disorders ◽

Psychiatric Clinic ◽

Bipolar Spectrum ◽

Bipolar Spectrum Disorders ◽

Brazilian Version ◽

Mood Disorder Questionnaire ◽

Psychiatric Population ◽

Spectrum Disorders

OBJECTIVE: Bipolar spectrum disorders are prevalent and frequently underdiagnosed and undertreated. This report describes the development and validation of the Brazilian version of the Mood Disorder Questionnaire, a screening instrument for bipolar spectrum disorders, in an adult psychiatric population. METHOD: A total of 114 consecutive patients attending an outpatient psychiatric clinic completed the Brazilian version of the Mood Disorder Questionnaire. A research psychiatrist, blind to the Mood Disorder Questionnaire results, interviewed patients by means of the mood module of the Structured Clinical Interview for DSM-IV ('gold standard'). RESULTS: The internal consistency of the Brazilian Mood Disorder Questionnaire, evaluated with Cronbach's alpha coefficient was 0.76 (95% CI; 0.69-0.92). Principal component analysis with varimax rotation indicated an 'irritability-racing thoughts' factor and 'energized-activity' factor, which explained 39.1% of variance. On the basis of the SCID, 69 (60.5%) individuals received a diagnosis of bipolar disorders. A Brazilian Mood Disorder Questionnaire screening score of 8 or more items yielded sensitivity of 0.91 (95% CI; 0.85-0.98), specificity of 0.70 (95% CI; 0.62-0.75), a positive predictive value of 0.82 (95% CI; 0.75-0.88) and a negative predictive value of 0.84 (95% CI; 0.77-0.90). CONCLUSION: The present data demonstrate that the Brazilian Mood Disorder Questionnaire is a valid instrument for the screening of bipolar disorders. The instrument needs to be validated in other settings (e.g., in general practice).

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Assessment and treatment of mood disorders in the context of substance abuse

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2015.17.2/btolliver ◽

2015 ◽

Vol 17 (2) ◽

pp. 181-190 ◽

Cited By ~ 20

Keyword(s):

Substance Abuse ◽

Substance Use ◽

Mood Disorders ◽

Substance Use Disorders ◽

Clinical Decision Making ◽

Bipolar Disorders ◽

Clinical Decision ◽

Public Health Burden ◽

Substance Dependent ◽

Treatment Research

Recognition and management of mood symptoms in individuals using alcohol and/or other drugs represent a daily challenge for clinicians in both inpatient and outpatient treatment settings. Diagnosis of underlying mood disorders in the context of ongoing substance abuse requires careful collection of psychiatric history, and is often critical for optimal treatment planning and outcomes. Failure to recognize major depression or bipolar disorders in these patients can result in increased relapse rates, recurrence of mood episodes, and elevated risk of completed suicide. Over the past decade, epidemiologic research has clarified the prevalence of comorbid mood disorders in substance-dependent individuals, overturning previous assumptions that depression in these patients is simply an artifact of intoxication and/or withdrawal, therefore requiring no treatment. However, our understanding of the bidirectional relationships between mood and substance use disorders in terms of their course(s) of illness and prognoses remains limited. Like-wise, strikingly little treatment research exists to guide clinical decision making in co-occurring mood and substance use disorders, given their high prevalence and public health burden. Here we overview what is known and the salient gaps of knowledge where data might enhance diagnosis and treatment of these complicated patients.

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