Screening for Bipolarity: Moodcheck
Download link below; but read this first...
This screening tool is not copyrighted. Anyone may use it without charge. However --
You could do more harm than good, using this test, if you do not recall the effects of "prevalence" on the predictive value of a test result. Below is a short review.
Briefly: "predictive value"
A test result is not a diagnosis, because tests are not perfect. Of course, neither are you. In most circumstances, however, you and the test are better than either alone. You don't need to remember how to calculate sensitivity,specificity or predictive values to understand that if a condition is very rare, most of the people you screen will not have the disease. If the test is not perfect, you will have many "false positives". Conversely, if the illness is common, then even with an imperfect test, a positive test result is much more likely to be a "true positive".
This logic also applies to your "clinical hunch". If you really don't think the patient could have bipolar disorder, a positive test result is more likely to be a false positive. And if you think "yes, this really could be bipolar", a positive test result is more likely to be a true positive.Phelps and Ghaemi, 2006
Of course, your clinical hunch will depend on your understanding of "bipolarity". When you have time, you should read about Bipolar II: the more you understand, the better your hunch, and the more accurate your interpretation of the screening test you came here to download.
Anatomy of the instrument
Part A, B. the Bipolar Spectrum Diagnostic Scale, a validated bipolar screening tool. Ghaemi, Zaratiequi , Vazquez, Shabani , Smith
Part C: information you need before prescribing an antidepressant (family history; negative prior diagnosis; and one of the powerful predictors of suicide risk )
Part D: non-manic bipolar markers (bipolar "soft signs") which are statistically associated with bipolar outcomes, and therefore will help you establish your clinical hunch.
You do not need to memorize the following numbers. All of the necessary cutoff values have been written into the test itself. Most of your patients will be able to do the scoring for you using the instructions provided.
Score less than 10, significant bipolarity is unlikely;
Score >13, bipolarity is likely.
Intermediate results require interpretation (see below).
Part C: a family history of bipolar disorder, if that diagnosis is relatively secure, is a strong bipolar marker; more than 8 boxes checked is also significant.Algorta
Part D: dark gray boxes carry more weight than light gray boxes, light gray greater than white -- but no cut-offs have been established.
What about a BSDS score between 10 and 13, or a low BSDS score but lots of grey areas circled on the back page? These are intermediate results that cannot be handled with a yes/no, black-or-white diagnostic system like the DSM-IV. My usual approach is to send patients to learn more about Bipolar II and "soft" versions of bipolar disorder, as suggested on the test page. Note that the "bipolar spectrum" approach to diagnosis has been recommended by a task force of the International Society for Bipolar Disorders. Phelps et al
download the MoodCheck bipolar screener