DOES SCREENING WITH THE MDQ AND EPDS IMPROVE IDENTIFICATION OF BIPOLAR DISORDER IN AN OBSTETRICAL SAMPLE?: Postpartum Screening with the MDQ and EPDS
Open accessAbstract
BACKGROUND: Women with bipolar disorder (BD) are at high risk for postpartum affective episodes and psychosis. Although validated screening tools are available for postpartum unipolar depression, few screening tools for hypomania/mania exist. Screening tools for BD in the postpartum period are essential for improving detection and planning appropriate treatment. We evaluated whether adding the Mood Disorders Questionnaire (MDQ) to the Edinburgh Postnatal Depression Scale (EPDS) increased the identification of BD in the early postpartum period. METHODS: Women (N = 1,279) who delivered a live infant and screened positive on the EPDS and/or MDQ at 4-6 weeks postbirth were invited to undergo an in-home Structured Clinical Interview for DSM-IV (SCID). RESULTS: Positive EPDS and/or MDQ screens occurred in 12% of the sample (n = 155). In home SCID diagnostic interviews were completed in 93 (60%) of the mothers with positive screens. BD was the primary diagnosis in 37% (n = 34). Women with BD screened positive on the EPDS and/or MDQ as follows: EPDS+/MDQ+ (n = 14), EPDS+/MDQ- (n = 17), and EPDS-/MDQ+ (n = 3). The MDQ identified 50% (17/34) of the women with BD and 6 additional cases of BD when the MDQ question regarding how impaired the mother perceived herself was excluded from the screen criterion. CONCLUSION: Addition of the MDQ to the EPDS improved the distinction of unipolar depression from bipolar depression at the level of screening in 50% of women with traditional MDQ scoring and by nearly 70% when the MDQ was scored without the impairment criterion.
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Standardized screening tools such as the Mood Disorder Questionnaire alone or in conjunction with the Edinburgh Postnatal Depression Scale are useful for screening for BD during pregnancy and postpartum.
“Standardized screening tools such as the Mood Disorder Questionnaire alone or in conjunction with the Edinburgh Postnatal Depression Scale are useful.521, 522, 523, 524”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [523]
The Conclusion and Results (page numbers unavailable) support using the MDQ with the EPDS to help identify bipolar disorder postpartum; the MDQ also identified some cases on its own. The Methods specify screening at 4–6 weeks after birth, so this study does not establish usefulness during pregnancy. (LLM, conf=0.87)
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Cites
Detection of Postnatal Depression: Development of the 10-item Edinburgh Postnatal Depression Scale
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987) · British Journal of Psychiatry · doi:10.1192/bjp.150.6.782 · Cited by 14,183 · see citing works
Perinatal Depression: A Systematic Review of Prevalence and Incidence
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000183597.31630.db · Cited by 3,282 · see citing works
Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M. A., Petukhova, M., & Kessler, R. C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.543 · Cited by 2,399 · see citing works
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., et al. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.11.1873 · Cited by 1,525 · see citing works
Wisner, K. L., Sit, D. K. Y., McShea, M. C., Rizzo, D. M., Zoretich, R. A., Hughes, C. L., Eng, H. F., Luther, J. F., Wisniewski, S. R., Costantino, M. L., et al. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.87 · Cited by 1,091 · see citing works
Self-citationGibson, J., McKenzie‐McHarg, K., Shakespeare, J., Price, J., & Gray, R. (2009) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2009.01363.x · Cited by 1,000 · see citing works
Effects of gonadal steroids in women with a history of postpartum depression
Bloch, M., Schmidt, P. J., Danaceau, M., Murphy, J., Nieman, L., & Rubinow, D. R. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.6.924 · Cited by 950 · see citing works
The Altman Self-Rating Mania Scale
Altman, E. G., Hedeker, D., Peterson, J. L., & Davis, J. M. (1997) · Biological Psychiatry · doi:10.1016/s0006-3223(96)00548-3 · Cited by 841 · see citing works
New Parents and Mental Disorders: A Population-Based Register Study
Munk-Olsen, T., Laursen, T. M., Pedersen, C. B., Mors, O., & Mortensen, P. B. (2006) · JAMA · doi:10.1001/jama.296.21.2582 · Cited by 727 · see citing works
Review of validation studies of the Edinburgh Postnatal Depression Scale
Eberhard‐Gran, M., Eskild, A., Tambs, K., Opjordsmoen, S., & Samuelsen, S. O. (2001) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2001.00187.x · Cited by 487 · see citing works
Development and validation of a scale for hypomanic personality.
Eckblad, M., & Chapman, L. J. (1986) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.95.3.214 · Cited by 479 · see citing works
A Review of Postpartum Psychosis
Sit, D., Rothschild, A. J., & Wisner, K. L. (2006) · Journal of Women's Health · doi:10.1089/jwh.2006.15.352 · Cited by 454 · see citing works
Self-citationGoyal, D., Gay, C., & Lee, K. A. (2010) · Women s Health Issues · doi:10.1016/j.whi.2009.11.003 · Cited by 439 · see citing works
Independent Assessment of Manic and Depressive Symptoms by Self-rating
Bauer, M. S. (1991) · Archives of General Psychiatry · doi:10.1001/archpsyc.1991.01810330031005 · Cited by 408 · see citing works
Development and validation of a scale for hypomanic personality.
Eckblad, M., & Chapman, L. J. (1986) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.95.3.214 · Cited by 399 · see citing works
Depue, R. A., Slater, J. F., Wolfstetter-Kausch, H., Klein, D., Goplerud, E., & Farr, D. (1981) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.90.5.381 · Cited by 395 · see citing works
Management of bipolar disorder during pregnancy and the postpartum period
Yonkers, K. A., Wisner, K. L., Stowe, Z., Leibenluft, E., Cohen, L., Miller, L., Manber, R., Viguera, A., Suppes, T., & Altshuler, L. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.4.608 · Cited by 394 · see citing works
Self-citationDepue, R. A., Slater, J. F., Wolfstetter-Kausch, H., et al. (1981) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.90.5.381 · Cited by 299 · see citing works
Identifying women at‐risk for postpartum depression in the immediate postpartum period
Dennis, C. ‐. E., Janssen, P. A., & Singer, J. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2004.00337.x · Cited by 262 · see citing works
Integrated perinatal health framework
Misra, D. P., Guyer, B., & Allston, A. (2003) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(03)00090-4 · Cited by 235 · see citing works
Sensitivity and specificity of a new bipolar spectrum diagnostic scale
Ghaemi, S. N., Miller, C. J., Berv, D. A., Klugman, J., Rosenquist, K. J., & Pies, R. W. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00196-4 · Cited by 223 · see citing works
Rethinking recommendations for screening for depression in primary care
Thombs, B. D., Coyne, J. C., Cuijpers, P. J., de Jonge, P., Gilbody, S. M., Ioannidis, J. P. A., Johnson, B. T., Patten, S. B., Turner, E. H., & Ziegelstein, R. C. (2011) · Canadian Medical Association Journal · doi:10.1503/cmaj.111035 · Cited by 221 · see citing works
Tsai, A. C., Scott, J. A., Hung, K. J., Zhu, J. Q., Matthews, L. T., Psaros, C., & Tomlinson, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0082521 · Cited by 168 · see citing works
Early postpartum symptoms in puerperal psychosis
Heron, J., McGuinness, M., Blackmore, E. R., Craddock, N. J., & Jones, I. R. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2007.01563.x · Cited by 144 · see citing works
Vieta, E., Sánchez‐Moreno, J., Bulbena, A., Chamorro, L., Ramos, J. L., Artal, J., Pérez, F., Oliveras, M., Valle, J., Lahuerta, J. J., et al. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.09.040 · Cited by 117 · see citing works
Genome-wide linkage and follow-up association study of postpartum mood symptoms
Mahon, P. B., Payne, J. L., MacKinnon, D. F., Mondimore, F. M., Goes, F. S., Schweizer, B., Jancic, D., NIMH Genetics Initiative Bipolar Disorder Consortium, BiGS Consortium, Coryell, W. H., et al. (2009) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09030417 · Cited by 112 · see citing works
Development, use, and factor analysis of a self-report inventory for mania
Shugar, G., Schertzer, S., Toner, B. B., & Gasbarro, I. D. (1992) · Comprehensive Psychiatry · doi:10.1016/0010-440x(92)90040-w · Cited by 111 · see citing works
Mood changes after delivery: role of the serotonin transporter gene
Sanjuan, J., Martin-Santos, R., Garcia-Esteve, L., Carot, J. M., Guillamat, R., Gutierrez-Zotes, A., Gornemann, I., Canellas, F., Baca-Garcia, E., Jover, M., et al. (2008) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.045427 · Cited by 109 · see citing works
Prevalence and predictors of maternal postpartum depressed mood and anhedonia by race and ethnicity
Liu, C. H., & Tronick, E. Z. (2013) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796013000413 · Cited by 101 · see citing works
Mild Hypomania (the Highs) can be a Feature of the First Postpartum Week
Glover, V. A. S., Liddle, P. F., Taylor, A., Adams, D., & Sandler, M. (1994) · The British Journal of Psychiatry · doi:10.1192/bjp.164.4.517 · Cited by 96 · see citing works
Screening for Bipolar Disorder with the Mood Disorders Questionnaire: A Review
Zimmerman, M. A., & Galione, J. N. (2011) · Harvard Review of Psychiatry · doi:10.3109/10673229.2011.614101 · Cited by 90 · see citing works
Screening for bipolar disorder during pregnancy and the postpartum period
Chessick, C. A., & Dimidjian, S. (2010) · Archives of Women s Mental Health · doi:10.1007/s00737-010-0151-9 · Cited by 87 · see citing works
Perinatal depression: a review of US legislation and law
Rhodes, A. M., & Segre, L. S. (2013) · Archives of Women's Mental Health · doi:10.1007/s00737-013-0359-6 · Cited by 86 · see citing works
Matthey, S., Phillips, J., White, T., Glossop, P., Hopper, U., Panasetis, P., Petridis, A., Larkin, M., & Barnett, B. (2004) · Archives of Women s Mental Health · doi:10.1007/s00737-004-0064-6 · Cited by 85 · see citing works
Clinical and Economic Effects of Unrecognized or Inadequately Treated Bipolar Disorder
Keck, P. E., Kessler, R. C., & ROSS, R. W. (2008) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000320124.91799.2a · Cited by 83 · see citing works
Validation of the Mood Disorder Questionnaire for screening for bipolar disorder in a UK sample
Twiss, J., Jones, S. H., & Anderson, I. M. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.12.235 · Cited by 80 · see citing works
Binder, E. B., Jeffrey Newport, D., Zach, E. B., Smith, A. K., Deveau, T. C., Altshuler, L. L., Cohen, L. S., Stowe, Z. N., & Cubells, J. F. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.12.001 · Cited by 69 · see citing works
Solomon, D. A., Leon, A. C., Maser, J. D., Truman, C. J., Endicott, J., Teres, J. J., & Keller, M. B. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0315 · Cited by 68 · see citing works
Diagnosis and classification of functional psychoses
Kendell, R. E. (1987) · British Medical Bulletin · doi:10.1093/oxfordjournals.bmb.a072198 · Cited by 67 · see citing works
Frey, B. N., Simpson, W., Wright, L., & Steiner, M. (2012) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12m07856 · Cited by 58 · see citing works
Kim, B., Wang, H. R., Son, J. I., Kim, C. Y., & Joo, Y. H. (2008) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2008.01.002 · Cited by 58 · see citing works
Screening for bipolar disorder: The utility and comparative properties of the MSS and MDQ measures
Parker, G. B., Fletcher, K., Barrett, M., et al. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.11.003 · Cited by 53 · see citing works
Screening for postpartum bipolar disorder: Validation of the Mood Disorder Questionnaire
Sharma, V., & Xie, B. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.11.026 · Cited by 45 · see citing works
Evaluating Universal Education and Screening for Postpartum Depression Using Population-Based Data
Farr, S. L., Denk, C. E., Dahms, E. W., & Dietz, P. M. (2014) · Journal of Women s Health · doi:10.1089/jwh.2013.4586 · Cited by 43 · see citing works
Adequacy of treatment received by diagnosed and undiagnosed patients with bipolar I and II disorders
Arvilommi, P., Suominen, K. S., Mantere, O. K., Leppämäki, S., Valtonen, H., & Isometsä, E. T. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0114 · Cited by 43 · cited 2× · see citing works
“Frey et al.[13] investigated the sensitivity and specificity of the MDQ in perinatal women (n = 150) referred to a women’s mental health clinic.”
BackgroundMethodDodd, S., Williams, L. J., Jacka, F. N., Pasco, J. A., Bjerkeset, O. A., & Berk, M. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902873706 · Cited by 43 · see citing works
Boschloo, L., Nolen, W. A., Spijker, A. T., Hoencamp, E., Kupka, R., Penninx, B. W. J. H., & Schoevers, R. A. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.05.078 · Cited by 29 · see citing works
Bobo, W. V., Wollan, P. C., Lewis, G. D., Bertram, S. L., Kurland, M., Vore, K., & Yawn, B. P. (2014) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2014.05.011 · Cited by 9 · see citing works
Mental Illness as a Risk Factor for Uninsurance Among Mothers of Infants
Noonan, K., Carroll, A., Reichman, N. E., & Corman, H. (2008) · Maternal and Child Health Journal · doi:10.1007/s10995-008-0424-3 · Cited by 8 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [41]Hirschfeld RM Williams JB Spitzer RL Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire American Journal of Psychiatry 2000 157 1873 1875 11058490
- [50]Chessick CA Dimidjian S Screening for bipolar disorder during pregnancy and the postpartum period Archives of women's mental health 2010 13 233 248 20198393
Cited by
Sorted by citations
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852 · see citing works
Postpartum psychiatric disorders
Meltzer-Brody, S., Howard, L. M., Bergink, V., Vigod, S., Jones, I., Munk-Olsen, T., Honikman, S., & Milgrom, J. (2018) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2018.22 · Cited by 357 · see citing works
ACOG Committee on Clinical Practice Guidelines–Obstetrics (2023) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000005200 · Cited by 294 · see citing works
Postpartum Psychosis: Madness, Mania, and Melancholia in Motherhood
Bergink, V., Rasgon, N., & Wisner, K. L. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.16040454 · Cited by 242 · see citing works
Self-citationBipolar postpartum depression: An update and recommendations
Sharma, V., Doobay, M., & Baczynski, C. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.05.014 · Cited by 67 · see citing works
- Authors
- Clark, C. T., Sit, D. K. Y., Driscoll, K., Eng, H. F., Confer, A. L., Luther, J. F., Wisniewski, S. R., & Wisner, K. L.
- Affiliations
- Northwestern University (US)
- University of Pittsburgh (US)
- VA Pittsburgh Healthcare System (US)
- Corresponding author
- Clark, Crystal T.
- ORCID
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2015-06-08
- Volume
- 32
- Issue
- 7
- Pages
- 518-526
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC4588053
- OpenAlex
- W1899135399
- Cited by
- 112
- References
- 49
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 1 · 2020: 6 · 2019: 5 · 2018: 8 · 2017: 63 · 2016: 7
- FWCI
- 27.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Child Health and Human Development (K12 HD055884)
- National Institute of Mental Health (R01 MH 071825)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- bipolar disorder, postpartum period, screening, Edinburgh Postnatal Depression Scale, hypomania, mania, major depressive disorder, postpartum psychosis
- MeSH terms
- Adult, Anxiety Disorders, Bipolar Disorder, Depressive Disorder, Female, Humans, Psychiatric Status Rating Scales, Substance-Related Disorders, Postpartum Period, Young Adult
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