Nursing unit 3 assignment – clinical preparation tool. 800words. 4


Assessment Instruments

I am retaking this class from the previous semester can you please redo this assignment? The instructor runs all paper thorough plagiarism site so it has to be different so it does not get flagged. Thanks

Unit 3 Assignment – Clinical Preparation Tool- MDQ



Course Number and Title



Bipolar and Related Disorders

Week X

DSM: Bipolar I Disorder

Instrument: Mood Disorder Questionnaire (MDQ)

Article: “Improving the Screening Instrument of Bipolar Spectrum Disorders: Weighted Korean Version of the Mood Disorder Questionnaire.”

Appropriateness for Dx: The Mood Disorder Questionnaire (MDQ) is used to diagnose bipolar disorders and is a widely employed, concise, and self-reported questionnaire. Hirschfeld et al. (2000) developed the MDQ to evaluate bipolar disorders within clinical settings, presenting a user-friendly format that allows patients to swiftly complete it with a pencil and paper. The instrument’s ease of administration contributes to its widespread adoption as a standard screening tool. Notable studies have been conducted to enhance the MDQ’s sensitivity, and one such study that is relevant to this discussion is by Hong et al. (2018), which focused on the Korean version of the questionnaire. The study identified that cultural differences could impact the representation of certain symptoms, particularly hypersexuality and distractibility. As a result, the authors modified the MDQ, removing these components to create a more culturally sensitive version. The adjustment aimed to differentiate between symptoms of depression and those specific to bipolar disorder, thereby refining the diagnostic accuracy of the instrument.

While the MDQ is often used as a screening tool for bipolar disorder, its sensitivity may vary depending on an individual’s background and cultural context; this raises the importance of considering cultural factors when interpreting the results. The MDQ, however, is not intended for making a definitive diagnosis; it serves as an effective screening tool for identifying individuals who may have Bipolar Spectrum Disorders, encompassing Bipolar I, Bipolar II, and Bipolar NOS. Studies suggest that the MDQ demonstrates a commendable screening accuracy as it can identify bipolar disorder in seven out of ten individuals. At the same time, it rules out nine out of ten individuals without bipolar disorder. Nevertheless, the MDQ alone cannot be the sole diagnostic tool for bipolar disorder or other mental health conditions. Instead, it represents one piece of the diagnostic puzzle, and comprehensive assessment and clinical judgment remain critical in accurately diagnosing mental health issues. Therefore, it is essential to consider the broader clinical context when interpreting the MDQ’s results.

Response to Therapy/Treatment:

As a screening instrument, the MDQ is primarily intended for identifying potential cases of Bipolar Spectrum Disorders and is not designed for therapeutic purposes. Once the screening process is completed, the MDQ utilizes closed-ended questions to categorize patients into positive or negative screening results. When an individual tests positive for Bipolar Spectrum Disorders based on the MDQ, it signals the need for a comprehensive medical evaluation to confirm the diagnosis and determine the most appropriate treatment plan. The MDQ’s role in therapy and treatment lies in its ability to flag potential cases of bipolar disorder, guiding healthcare professionals to conduct further assessments and initiate appropriate interventions. While the questionnaire provides valuable insights, it does not replace the need for a more in-depth evaluation and ongoing patient condition monitoring during treatment.

Therapeutic interventions for Bipolar Spectrum Disorders typically involve a multifaceted approach, which may include psychotherapy, medication management, lifestyle changes, and support from healthcare providers. Once a formal diagnosis is confirmed through a comprehensive evaluation, healthcare practitioners can create custom treatment plans to address a client’s specific needs and symptoms—the MDQ’s role shifts from screening to monitoring patient progress throughout the treatment process. Clinicians can gauge the effectiveness of the treatment and assess any changes in symptom severity or patterns by administering the MDQ at regular intervals. Continuous evaluation enables healthcare providers to make informed decisions regarding adjustments to the treatment plan or the incorporation of additional therapeutic modalities. Healthcare practitioners create personalized and comprehensive treatment approaches that improve patient outcomes by combining MDQ results with thorough clinical assessments and patient-specific characteristics.


The MDQ is a useful tool for detecting Bipolar I disorder, encompassing episodes of mania and depression. However, its sensitivity is considered insufficient for diagnosing Bipolar II conditions, characterized by hypomania and depression. Additionally, the MDQ cannot be utilized to diagnose Bipolar (NOS) conditions. The MDQ has sections one, two, and three. The first section contains thirteen close-ended questions, and the second and third have only one question each. Patients with a score of 7/13 in the first two sections and classified as “moderate” or “severe” in section three are classified as having bipolar disorder.

When the MDQ is employed in outpatient clinics, particularly with a patient population largely affected by mood disorders, it demonstrates a specificity of 0.90 and a sensitivity of 0.73. On a broader population level, the sensitivity of the MDQ is lower, at 28%, while the specificity is higher, at 97% (Zimmerman, 2021). It’s worth noting that patients with confirmed bipolar disorder tend to show higher sensitivity (0.58) compared to those with unipolar depression (0.67). Furthermore, when the MDQ is used to assess depression in patients, its sensitivity is 0.58, and its specificity is 0.93. These results suggest that the validity and reliability of the MDQ can be greatly influenced by the characteristics of the population being evaluated. The MDQ is a valuable screening tool for detecting Bipolar I disorder but may not be as effective in identifying Bipolar II and NOS conditions. Its performance is influenced by the patient population being assessed, with higher sensitivity observed in patients with confirmed bipolar disorder. However, the questionnaire’s sensitivity is lower when applied to a broader population, suggesting the importance of considering the context and characteristics of the individuals being evaluated when interpreting the MDQ’s results.

Limitations: Limitations:

One notable limitation of the MDQ is its varying sensitivity in diagnosing disorders within the Bipolar Spectrum. While it exhibits higher sensitivity for identifying Bipolar I disorder, its performance diminishes when dealing with other conditions on the spectrum (Humpston et al., 2020). Notably, patients with severe symptoms tend to yield more accurate results, while those lacking manic symptoms may not be effectively identified through this questionnaire. Consequently, relying solely on the MDQ may result in potential misdiagnosis or underdiagnosis of certain bipolar conditions.

Moreover, a critical drawback of the MDQ is its limited capacity to assess treatment outcomes. The instrument primarily focuses on capturing an individual’s lifetime history of symptoms. Still, it does not provide insight into the current severity of mood issues or the response to ongoing treatment interventions. Consequently, clinicians may face challenges in determining the effectiveness of therapeutic approaches and making informed decisions regarding treatment adjustments. Another noteworthy concern regarding the MDQ is related to its administration by the user, which introduces a higher potential for bias in the results. As the tool relies on self-reporting by the patient, various factors such as individual perceptions, cognitive biases, and subjective interpretations may influence the responses; this could impact the accuracy and reliability of the collected data, leading to potential inaccuracies in the screening process. Clinicians should supplement the MDQ with additional assessment measures and clinical evaluations to address these limitations and obtain a more comprehensive and accurate understanding of a patient’s condition. Combining information from various sources can help mitigate the impact of individual biases and enhance the diagnostic process, leading to more effective treatment planning and better patient outcomes.


Hirschfeld, R. M. A., Williams, J. B. W., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E., Lewis, L., McElroy, S. L., Post, R. M., Rapport, D. J., Russell, J. M., Sachs, G. S., & Zajecka, J. (2000). Development and Validation of a Screening Instrument for Bipolar Spectrum Disorder: The Mood Disorder Questionnaire.
American Journal of Psychiatry,
157(11), 1873–1875.

Hong, N., Bahk, W.-M., Yoon, B.-H., Min, K. J., Shin, Y. C., & Jon, D.-I. (2018). Improving the Screening Instrument of Bipolar Spectrum Disorders: Weighted Korean Version of the Mood Disorder Questionnaire.
Clinical Psychopharmacology and Neuroscience,
16(3), 333–338.

Humpston, C. S., Bebbington, P., & Marwaha, S. (2020). Bipolar disorder: Prevalence, help-seeking and use of mental health care in England. Findings from the 2014 Adult Psychiatric Morbidity Survey.
Journal of Affective Disorders,

Zimmerman, M. (2021). Using Screening Scales for Bipolar Disorder in Epidemiologic Studies: Lessons Not Yet Learned.
Journal of Affective Disorders,
292, 708–713.

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