Nursing: The Mood Disorder Questionnaire (MDQ)

Mood Disorder Questionnaire (MDQ)

A possible tool used for the screening of bipolar disorder is the Mood Disorder Questionnaire. The MDQ is a validated tool designed to assist individuals recognize bipolar disorder’s signs and symptoms, including depression and mania (Vieta, 2011). The tool was developed by experts comprising of consumer advocates, psychiatrists and researchers to help in timely and accurate examination of bipolar disorder in primary care setting. The tool helps people understand if they suffer from the condition or not. The Mood Disorder Questionnaire is a self-assessment tool, which is easy to use and which helps patients in consultations with doctors regarding mood issues (Vieta, 2011).

A Description of the MDQ and How It Is Utilized

The MDQ should only be used solely in the context of screening (Vieta, 2011). It means that it can only be used for screening purposes and not as a diagnostic tool. The Mood Disorder Questionnaire comprises of 15 questions that take approximately 5 minutes to answer. The first 13 questions are about the possible symptoms and are completed with either yes or no answer. The remaining two questions evaluate the history of the family, past diagnoses and the severity of the disease (Vieta, 2011). A positive screen is scored if the following three criteria are met:

Question 1 (the 13 questions): has at least 7 positive responses

Question 2: has a positive response

Question 3: has either a moderate or serious response

The tool is easy to use and it can either be administered by the clinician, or self-administered by the patient (Vieta, 2011). The MDQ has a good sensitivity, as well as specificity. It can identify 7 out of 10 patients suffering from the disorder and screen 9 out of 10 patients.

The Mood Disorder Questionnaire (MDQ) can be administered either by the clinician or self-administered by the patient (Vieta, 2011). The use of the MDQ does not require any special training. The intended users complete the questionnaire and, using the scoring evaluation, determine if they suffer from the disorder or not (Vieta, 2011).

Reliability and Validity of the MDQ

Validity is a term used to denote the believability and credibility of the research. It is the degree to which a test provides information regarding what it was intended to measure (Drost, 2011). Validity manifests itself in the context of the test, the purpose of the test and the targeted population. Validity determines whether the findings are genuine. There are two types of validity. The first one is internal validity, which shows whether the instruments used in the research measured what they were intended to measure or not (Drost, 2011). Second is external validity, whereby the results can be reported on a universal scale, irrespective of the immediate study (Drost, 2011).

On the other hand, reliability shows the repeatability of the results (Drost, 2011). For instance, if a study had to be repeated more than once, would the results be the same? If yes, then the study is reliable. In this case, if several MDQs were used to screen a certain population, the findings from all the tools should be the same in order to report that the data is reliable. Research necessitates dependable measurements, which are reliable to the degree they occur. Therefore, reliability is the extent to which a test constantly measures specific data.

Both reliability and validity can be affected by errors. Errors of measurement that affect reliability are called random errors, while those that affect the validity are called constant or systematic errors (Drost, 2011).

Various studies have been performed to determine the validity and reliability of the Mood Disorder Questionnaire. Most scholars agree on the validity and reliability of the tool. For instance, in a study performed to test the Korean version of the MDQ, the results indicated substantial validity and reliability (Jona et al. 2009). The study reported that the tool is essential in the screening of the disorder in Korea. Nonetheless, researchers suggested that the initial criteria have to be improved to enhance sensitivity (Jona et al. 2009). In another study, testing for reliability, the MDQ was compared with other screening tools, such as the hypomania checklist (HCL- 32) and clinical structured interview (Sasdelli et al. 2013). The findings reported that the Mood Disorder Questionnaire has adequate limitations for the screening of bipolar II disorder in non-clinical populations.  

Resources Available at Calgary Zone for People with Bipolar Disorder

Support Groups

Calgary Association of Self Help (CASH) is a support group that offers flexible and patient-centered services (CASH, 2015). It enhances the capability of adults suffering from mental illnesses, such as bipolar disorder, depression and anxiety among others. It also deals with other issues, such as social isolation, poverty and stigma. To achieve it, CASH has implemented a number of programs and services, including support, counseling, recreational and skills development (CASH, 2015). Intervention and counseling services help lessen dependence on emergency services. Counseling services include crisis prevention, goal setting, assessment, resource information and problem-solving (CASH, 2015). Recreational and social services help patients feel incorporated into the society. Most clients may lack access to such services due to their limited earnings. CASH also offers a safe environment where clients are understood. They integrate themselves with other people sharing similar experiences. It is provided in an atmosphere of hope and acceptance. The services are considered as being reliable and valid. They assist clients obtain new skills, learn socializing skills, boost confidence, rebuild self-esteem and mitigate social isolation (CASH, 2015). Such aspects are important in dealing with the bipolar disorder. Consequently, it alleviates the burden on friends, families, as well as employees who are impacted negatively.

CASH has implemented two programs to help people with mental disorders. The first one is the Resource/Activity Centre (RAC). It is a social center opened throughout the year but at specific hours. During weekdays, it operates between 10:00 a.m. and 9:00 p.m. (CASH, 2015). During holidays and weekends, it operates between 12:00 p.m. and 8:00 p.m. (CASH, 2015). For clients to access the service, they are required to fill an admission form provided by a mental health worker. The worker offers direct support and links the client to other available services. The other program is the Mental Health Support Groups. It is a stop-by service provided from Mondays to Thursdays between 1:30 p.m. and 3:30 p.m. (CASH, 2015). It means that clients willing to access the service can visit the establishment at the designated time. During such sessions, clients are provided with mutual aid, meaningful topics for discussion, peer support and resources identification. They are guided, supported and encouraged by a staff facilitator.

Certainly, services offered by CASH meet the needs of both the clients and their families. Clients suffering from bipolar disorder need counseling support, skills development, recreational and social support, which are provided by the support group. To ensure reliability of their services, CASH communicates with other mental health experts and community services to guarantee continuity of care and synchronized interventions (CASH, 2015). They enable clients develop coping strategies vital in sustaining mental wellness and community involvement.

In and Out-Patient Services

Claresholm Centre for Mental Health & Addictions is an in and out-patient community center (AHS, 2015). It focuses on providing education and treatment for adults suffering from mental disorders or addiction. The services offered assist clients meet, sustain and reach their general mental health and welfare requirements (AHS, 2015). The programs help patients manage their illness, boost independence and cope with their community atmosphere. For some time, the Centre has helped people with various mental illnesses, including bipolar disorder among other diseases. It offers various services to people with mental disorders. They include Community Support Programs, Active Rehabilitation Program, Vocational Rehabilitation Services and Extended Treatment Program. Such services provide clients with coping skills, counseling support, social, as well as interpersonal skills.

To access services provided by Claresholm Centre for Mental Health & Addictions, clients need to inquire for admission or have a referral letter addressed to the Admission Coordinator (AHS, 2015). Current psychiatric assessment together with a referral letter written by the attending psychiatric consultant is the requirements for an admission referral. An admission Committee at Centre is responsible for assessing the applications, after which they make an admission decision.

To ensure optimum care is provided to patients, Claresholm Centre for Mental Health & Addictions uses the services of professionals. They include psychiatrists, nurses, physicians, psychologists and social workers among other mental health practitioners. Such experts work to ensure the development of their patients towards mental wellness. In addition to the in-patient services offered at the Centre, follow-up is also provided once a patient has been discharged into the community. Outreach interventions and outpatient services are synchronized, forming an inclusive treatment model for patients (AHS, 2015). It boosts self-reliance among patients, reducing dependence on their families. It also reduces financial strain, stigma and restores damaged relationships.

There is no available information indicating how the resources assist families caring for members with bipolar disorder. According to communicators/resource people, who work as social workers at a psychiatric unit in the hospital, there is no financial assistance extended to families. In addition, support for families in all other aspects, including psychological support, is also minimal.

Service Gaps and Recommendations

The analysis shows a gap in service offering. Although the support groups and the inpatient and outpatient services endeavor at enhancing the mental wellness of people with bipolar disorder, it is certainly that they do not assist the families of people with the condition. The impact on families is adverse, meaning that they should be supported in different aspects. They face financial burdens, emotional distress, feel sorrowful and grieved and their regular routines are disrupted (Austin & Boyd, 2015). A key recommendation is that services should be included to help families with people suffering from bipolar disorder (Austin & Boyd, 2015). They should include counseling services to help them acknowledge, understand and cope with the situation. In addition to meeting their needs, the families become well-informed on how to treat the patients in order to enhance their welfare. The counseling services also act as a way of encouragement and inspiration to families, who, in turn, implement coping strategies to deal with the disorder once it arises (Austin & Boyd, 2015). Financial support should also be provided considering that the families face financial burdens and using the available resources to cater for the family needs. By integrating such aspects into the patient treatment model, there is an evidence of optimum care for all who are affected.

Social Determinants of Health

The health of communities and individuals is affected by various factors referred to as determinants of health (Larsson, 2015). Social determinants of health refer to environmental conditions which impact health outcomes (Larsson, 2015). In such case, social support network is a determinant that impact both inpatient and community follow-up with mental health clients. Research indicates that relationships with friends, families and communities have significant effect on well-being (Larsson, 2015). Greater support is associated with better health. It means that the kind of support a client receives from the environment at a greater extent influences health outcomes. The second determinant is culture (Larsson, 2015). Cultural beliefs vary from one community to the other. The traditions, customs and beliefs of a certain community or family impact the health outcome of the client. For people suffering from bipolar disorder, their families’ act as their representatives while seeking care. What the family believes in impacts the kind of care provided, as well as the client’s health outcomes.

Conclusion

As evidenced in the paper, the Mood Disorder Questionnaire is an important tool for screening of bipolar disorder. The tool was developed and designed to be used in the primary health care setting to timely and accurately evaluate the level of bipolar disorder. It is an instrument easy for usage that does not requires specialized training. The MDQ has been tested for validity and reliability, and most scholars agree that the tool is useful in the screening of bipolar disorder.

There are various resources which cater for individuals with mental illnesses in Canada. For the purpose of current paper, two resources have been evaluated. They are support groups, which include CASH and in an out-patient services, which are provided by Claresholm Centre for Mental Health & Addictions. The Center offer numerous services, including counseling, social and recreational, skills development, support programs and rehabilitation services. The services are useful to patients in a way that they enhance their mental well-being and general welfare. However, a service gap exists as little attention is paid to the families of the clients. As a recommendation, various services, including counseling and financial support, should be included to care for families.

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