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Nevada Family Psychiatry

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Mood Disorder Questionnaire

The MDQ is used as a beginning screening tool for people with depression who also have “elevated” mood states. It can be used as one of many tools in investigating Manic-Depression/ Bipolar Disorder.

To download the hard copy of this form, click the button below. You are welcome to fill out that version and bring it in or submit the form by filling it out on this page here.

Download the English Form

Download the Spanish Form

Has there ever been a period of time when you were not your usual self and...

...you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble?

Yes
No

...you were so irritable that you shouted at people or started fights or arguments?

Yes
No

...you felt much more self-confident than usual?

Yes
No

...you got much less sleep than usual and found that you didn’t really miss it?

Yes
No

...you were more talkative or spoke much faster than usual?

Yes
No

...thoughts raced through your head or you couldn’t slow your mind down?

Yes
No

...you were so easily distracted by things around you that you had trouble concentrating or staying on track?

Yes
No

...you had more energy than usual?

Yes
No

...you were much more active or did many more things than usual?

Yes
No

...you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night?

Yes
No

...you were much more interested in sex than usual?

Yes
No

...you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky?

Yes
No

...spending money got you or your family in trouble?

Yes
No

If you checked YES to more than one of the above, have several of these ever happened during the same period of time?

Yes
No

How much of a problem did any of these cause you - like being unable to work; having family, money or legal troubles; getting into arguments or fights?

No Problems
Minor Problem
Moderate Problem
Serious Problem

Scoring

If you checked 7 or more “yes" answers this indicates some concerning energetic, impulsive or “manic” like symptoms. If you have depression periods as well this could suggest a possible mood swing problem.

If you would like to schedule an appointment to discuss the results of this test or any other concerns please follow the “Contact” link below.

Email to Send Test Results To? *

Phone

(702) 217-8030
JSomers@Psychiatry.vegas

4580 S. Eastern Ave. Suite #33
Las Vegas, NV 89119

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Nevada Family Psychiatry
JSomers@Psychiatry.vegas | (702) 217-8030

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