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5 June 2006
Asking parents to complete the Mood Disorder Questionnaire-Adolescent Version (MDQ-A) with regard to their adolescents' symptoms may be a useful instrument for screening for bipolar disorder, study findings suggest.
"The MDQ, a 13-item self-report scale, has been shown to be a valid instrument for the screening of bipolar disorders in adults across a wide array of settings, including psychiatric outpatient clinics, psychiatric inpatient units, the general population, and primary care practices," note Karen Dineen Wagner (University of Texas Medical Branch, Galveston, USA) and colleagues.
To determine the validity of the MDQ as a screening instrument for bipolar disorders in an adolescent outpatient psychiatric population, the team used three versions: self-report of symptoms by adolescent; attributional report based on how the adolescent believed teachers or friends would describe their symptoms; and parent report of adolescent's symptoms.
The three versions were administered to 104 adolescents and their parents. DSM-IV diagnoses were made based on the clinician-administered Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL).
According to this measure, 33 adolescents were diagnosed with bipolar I disorder, one with bipolar II disorder, six with bipolar disorder not otherwise specified, and one adolescent had cyclothymia.
The average number of positive items on the MDQ-A for the entire group were 6.0 for parent report, 6.3 for self-report, and 6.0 for attributional report.
Further analysis showed that, based on a cutoff of five items, parent report predicted bipolar disorder with a sensitivity of 72% and specificity of 81%. Self-report was associated with a sensitivity of 38% and a specificity of 73%, while the values for attributional report were 38% and 74%, respectively.
Statistically, parent report proved to be superior to either self-report or attributional report.
The researchers note in the Journal of Clinical Psychiatry that the sensitivity and specificity for parent report on the MDQ-A is similar to that for the MDQ when given to adults in a psychiatric outpatient clinic.
"The MDQ-A adds to the armentarium of screening instruments for bipolar disorder in youth," they say.
"Administration of the MDQ-A to the parents of adolescents in a psychiatric outpatient clinic may facilitate recognition of bipolar disorder in these youths."
Source: J Clin Psychiatry 2006; 67: 827–830
©2006 Current Medicine Group Ltd
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