Validation of the Mood Disorder Questionnaire in the general population in Hong Kong

Abstract

Objective: The objective of the study was to determine the reliability and validity of a Chinese version of the Mood Disorder Questionnaire (MDQ) in the general population in Hong Kong. Methods: One thousand five hundred eighteen adults aged at least 18 years were randomly drawn from the general population and interviewed using a lay-administered version of the MDQ. A subsample of 114 randomly selected participants received a telephone-based Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition. Six subjects were diagnosed to have bipolar disorder (bipolar I = 1, bipolar II = 4, and bipolar not otherwise specified = 1), 13 had substance/alcohol use disorder, and 95 had neither bipolar nor substance/alcohol use disorder. We determined the internal consistency, factor structure, and concurrent validity of the Chinese MDQ. Results: The Cronbach α coefficient of the Chinese MDQ was 0.78. Principal component analysis with varimax rotation indicated a "euphoria-irritability-racing thoughts" factor, an "energized-activity" factor, and a "risky behavior" factor, which explained 46.6% of the rotated variance. There were significant differences in MDQ scores between the bipolar and non-bipolar non-substance/alcohol use disorder groups. The performance of the Chinese MDQ for detecting bipolar disorder was limited by a low sensitivity. Using the original cutoff criterion, defined as clustering of 7 or more symptoms that caused moderate or severe problems, the sensitivity was 0%, whereas the overall specificity was 95.4%. Lowering the cutoff criterion to a symptom score of at least 7 that caused minor or more problems yielded the best sensitivity (0.50) and specificity (0.92). Conclusion: The Chinese MDQ is a reliable and valid measure of bipolar disorder in the community. © 2009 Elsevier Inc. All rights reserved.