{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:57Z","timestamp":1787028657328,"version":"build-2736575974"},"reference-count":159,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T00:00:00Z","timestamp":1745712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003197","name":"Agenzia Italiana del Farmaco","doi-asserted-by":"publisher","award":["FARM54S73S"],"award-info":[{"award-number":["FARM54S73S"]}],"id":[{"id":"10.13039\/501100003197","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The Mood Disorder Questionnaire (MDQ) is a widely used tool for the early detection of Bipolar Disorder (BD), yet its diagnostic accuracy remains debated. In particular, the MDQ often yields false positives in individuals with anxiety, stress-related, or personality disorders, raising questions about its clinical utility. This study aimed primarily to evaluate the sensitivity, specificity, and predictive values of the MDQ in identifying BD within a large, community-based sample using structured clinical interviews. Additionally, we explored the construct of DYMERS (Dysregulation of Mood, Energy, and Social Rhythms Syndrome), a proposed condition characterized by mood instability, hyperactivation traits, and rhythm dysregulation among MDQ-positive individuals without a formal psychiatric diagnosis. Methods: A total of 4999 adults were surveyed across six Italian regions using a stratified random sampling method. Psychiatric diagnoses were established using DSM-IV-TR criteria via the Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS). The MDQ was administered face to face in its validated Italian version, with a positivity cut-off of \u22657. The MDQ exhibited low sensitivity and high specificity (0.962; 95% CI: 0.961\u20130.963). Results: Among 2337 analyzable cases, the MDQ showed high specificity (96.2%) but low sensitivity (42.9%) for BD, indicating limited effectiveness as a screening tool. In clinical terms, this implies that while MDQ-positive individuals are unlikely to be false positives, a substantial proportion of true BD cases are not identified. Notably, a significant subgroup of MDQ-positive individuals without psychiatric diagnoses displayed features consistent with DYMERS. Conclusions: Our findings confirm the limited screening value of the MDQ for BD in community samples. However, MDQ positivity may help identify a broader spectrum of mood and rhythm dysregulation not captured by current diagnostic systems. Future research should focus on validating DYMERS as a clinical entity and on developing targeted diagnostic instruments capable of capturing this emerging dimension of psychopathology.<\/jats:p>","DOI":"10.3390\/jcm14093017","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T09:39:47Z","timestamp":1745833187000},"page":"3017","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Inaccuracy of the Mood Disorder Questionnaire for Bipolar Disorder in a Community Sample: From the \u201cDYMERS\u201d Construct Toward a New Instrument for Detecting Vulnerable Conditions"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5049-4614","authenticated-orcid":false,"given":"Elisa","family":"Cantone","sequence":"first","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Urban","sequence":"additional","affiliation":[{"name":"University Hospital of Cagliari, 09042 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1245-016X","authenticated-orcid":false,"given":"Giulia","family":"Cossu","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0645-3006","authenticated-orcid":false,"given":"Michela","family":"Atzeni","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3437-8664","authenticated-orcid":false,"given":"Pedro Jos\u00e9","family":"Fragoso Castilla","sequence":"additional","affiliation":[{"name":"PhD Program in Tropical Medicine, Universidad Popular del Cesar, Valledupar 200001, Colombia"},{"name":"Microbiology Program, Universidad Popular del Cesar, Valledupar 200001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4838-5993","authenticated-orcid":false,"given":"Shellsyn","family":"Giraldo Jaramillo","sequence":"additional","affiliation":[{"name":"Faculty of Health, Universidad Popular del Cesar, Valledupar 200001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0706-9687","authenticated-orcid":false,"given":"Mauro Giovanni","family":"Carta","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"},{"name":"PhD Program in Tropical Medicine, Universidad Popular del Cesar, Valledupar 200001, Colombia"},{"name":"Department of Nursing, Universidad Popular del Cesar, Valledupar 200001, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9155-4740","authenticated-orcid":false,"given":"Massimo","family":"Tusconi","sequence":"additional","affiliation":[{"name":"University Hospital of Cagliari, 09042 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1111\/j.1399-5618.2009.00755.x","article-title":"Performance of the Mood Disorders Questionnaire in a Psychiatric Outpatient Setting","volume":"11","author":"Zimmerman","year":"2009","journal-title":"Bipolar Disord."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19035","DOI":"10.4088\/JCP.09m05161yel","article-title":"Screening for Bipolar Disorder and Finding Borderline Personality Disorder","volume":"71","author":"Zimmerman","year":"2010","journal-title":"J. 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