Bipolar Screening

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 you got in to 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 you didn’t really miss it?

		Yes
		No

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

		Yes
		No

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

		Yes
		No

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

		Yes
		No

... you had much more energy than usual?

		Yes
		No

... you were much more social or outgoing than usual, for example you telephoned friend in t he 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 though were excessive, foolish or risky?

		Yes
		No

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

		Yes
		No

If you checked yet 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 able to work, having family, money or legal troubles, getting in to arguments or fights?

		No problem
		Minor problem
		Moderate problem
		Serious problem

Have any of your blood relatives (children, siblings parents, grandparents, aunts, uncles,) had manic-depressive illness or bipolar?

		Yes
		No

Has a health professional ever told you that you have manic-depressive illness or bipolar disorder?

		Yes
		No

Positive screen for bipolar disorder requires:

“Yes” to at least 7 of the 13 parts in question 1 and
“Yes” to question 2, and
“Moderate” or “Serious” to question 3

This is meant for screening purposes only and is not to be used as a diagnostic tool.

Reference: Hirschfield RMA, Williams JBS, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire. Am J Psychiatry, 2000; 157: 1873-1875

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