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Mood Disorder - Self Assessment


Mood Disorders Questionnaire


Hirschfeld RM, Williams JB, Spitzer RL, Calabrese JR, Flynn L, Keck PE Jr,
Lewis L, McElroy SL, Post RM, Rapport DJ, Russell JM, Sachs GS, Zajecka J
Am J Psych 157(11):1875 (appendix 1), November 2000.

This form is best viewed in landscape on phones.


1. Has there ever been a period of time when you were not your usual self and (while not using drugs or alcohol) …
Yes
No
…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? (circle yes or no for each line please)
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 much more talkative or spoke faster than usual?
Yes
No
…thoughts raced through your head or you couldn’t slow you 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 much 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
…spending money got you or your family into trouble?
Yes
No
Total number of “Yes” responses to question 1:
2. 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
3. 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 Problem Minor Problem Moderate Problem Serious Problem

Scoring:

An individual is considered positive for Bipolar Disorder if they answered:

1. “Yes” to at least 7 of the 13 items in question 1 AND
2. “Yes” to question number 2 AND
3. “Moderate” or “Serious” to question number 3.

All three of the criteria should be met. A positive screen indicates that the person should be evaluated for Bipolar Spectrum Disorder by a mental health professional.

Note: This questionnaire is provided for educational purposes only. It is not a substitute for consulting with a health professional. Even if an individual’s score on the questionnaire is “negative,” it is very important to consult with a primary care doctor or a mental health professional if there are concerns.


 

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