Mood Disorder Questionnaire (MDQ)

Patient Name:

Date:

Date

Please answer each question to the best of your ability.

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?

YESNO

Has there ever been a period of time when you were not your usual self and you were so irritable that you shouted at people or started fights or arguments?

YESNO

Has there ever been a period of time when you were not your usual self and you felt much more self-confident than usual?

YESNO

Has there ever been a period of time when you were not your usual self and you got much less sleep than usual and found you didn't really miss it?

YESNO

Has there ever been a period of time when you were not your usual self and you were much more talkative or spoke much faster than usual?

YESNO

Has there ever been a period of time when you were not your usual self and thoughts raced through your head or you couldn't slow your mind down?

YESNO

Has there ever been a period of time when you were not your usual self and you were so easily distracted by things around you that you had trouble concentrating or staying on track?

YESNO

Has there ever been a period of time when you were not your usual self and you had much more energy than usual?

YESNO

Has there ever been a period of time when you were not your usual self and you were much more active or did many more things than usual?

YESNO

Has there ever been a period of time when you were not your usual self and you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night?

YESNO

Has there ever been a period of time when you were not your usual self and you were much more interested in sex than usual?

YESNO

Has there ever been a period of time when you were not your usual self and you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky?

YESNO

Has there ever been a period of time when you were not your usual self and spending money got you or your family into trouble?

YESNO

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

YESNO

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 problemMinor problemModerate problemSerious problem

The Mood Disorder Questionnaire is appropriate for use with adults aged 18 and older. This is a screening tool and is not intended to provide a diagnosis.

©2000 by Robert M.A. Hirschfeld, MD. Reprinted with permission. SUNOVION and sis are registered trademarks of Sumitomo Dainippon Pharma Co., Ltd. Sunovion Pharmaceuticals Inc. is a U.S. subsidiary of Sumitomo Dainippon Pharma Co., Ltd. ©2018 Sunovion Pharmaceuticals Inc. All rights reserved. 2/18 LAT415-18

Mood Disorder Questionnaire (MDQ)

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