Quick Answer
MDQ scoring flags possible bipolar disorder when someone answers yes to 7 or more of 13 symptom items, says several happened during the same period, and rates them as causing a moderate or serious problem. The HCL-32 is a longer checklist aimed at hypomania. Both are screening tools that point toward a full evaluation, not a diagnosis.
Understanding MDQ Scoring and the HCL-32
The Mood Disorder Questionnaire, or MDQ, is a brief self-report form used to screen for bipolar disorder. Question 1 lists 13 experiences, such as feeling so good or hyper that others noticed, needing much less sleep without missing it, racing thoughts, talking faster, being easily distracted, having much more energy, spending money that caused trouble or acting in ways that were unusual for you. Question 2 asks whether several of these happened during the same period of time. Question 3 asks how much of a problem they caused, from no problem to a serious problem, such as trouble at work, with family, money or the law. This guide is part of our full set of New York bipolar depression guides.
According to the University of Washington’s scoring summary, a screen is positive only when all three parts line up: yes to 7 or more of the 13 items, yes to the same-period question, and a rating of moderate or serious problem. The same summary notes the MDQ is better at picking up bipolar I disorder, with full manic episodes, than bipolar II, where highs are milder hypomania. That’s one reason a negative MDQ doesn’t fully rule out bipolar disorder, especially when depression has been recurrent or hasn’t responded to antidepressants. Our guide on the PHQ-9 and bipolar screening explains how depression scores and bipolar screening fit together.
For New Yorkers whose depression keeps coming back, a short bipolar screen can be the first clue that something different is going on. NIMH estimates that 2.8% of U.S. adults had bipolar disorder in the past year, at similar rates in men (2.9%) and women (2.8%). Secure video visits from anywhere in New York can make it easier to start bipolar care and keep regular follow-ups without extra travel.
How the MDQ is scored, what the HCL-32 adds, and why screening isn’t diagnosis are the three ideas this guide covers.
Asking someone who knows you
People in a depressive episode often don’t remember earlier highs clearly, or see them only as good times. A partner, parent or close friend may recall periods when you slept very little, talked fast, spent unusually or seemed different. With your permission, their observations can be valuable. Some clinicians ask a family member to complete parts of a checklist too. Combining your own report with someone else’s view gives a more accurate picture than either alone.
Why the distinction matters
Getting the diagnosis right shapes treatment. Bipolar depression is treated differently from unipolar depression. Antidepressants taken alone can sometimes trigger mania or rapid cycling in people with bipolar disorder, and several medications are approved specifically for bipolar depression. A careful screen and evaluation help avoid years of treatment that doesn’t fit. That’s why clinicians often screen anyone with depression for bipolar features before starting or changing medication.
Key Takeaways
- The MDQ is positive with 7 of 13 symptoms, a shared time period and moderate or serious impact.
- The MDQ is better at detecting bipolar I than bipolar II.
- The HCL-32 focuses on milder hypomanic periods that are easy to miss.
- A positive screen leads to a careful clinical interview.
MDQ Scoring and the HCL-32 at a glance
| Part | What counts |
|---|---|
| Question 1 | Yes to 7 or more of 13 symptom items |
| Question 2 | Several happened during the same period |
| Question 3 | Caused a moderate or serious problem |
| Result | Positive screen: needs full evaluation |
What the HCL-32 adds
The Hypomania Checklist, or HCL-32, is a longer, 32-item questionnaire built specifically to pick up hypomania, the shorter and milder highs of bipolar II that people often remember as productive or happy stretches rather than illness. It asks about periods of more energy, confidence, talkativeness, activity, risk-taking or less need for sleep, and about how those periods affected work and relationships. Because hypomania can feel good, people often don’t mention it unless asked directly. A checklist like this helps surface those memories so they can be explored carefully in the interview.
Why screening isn't diagnosis
A positive MDQ means bipolar disorder is possible, not certain. Other conditions can produce similar answers, including ADHD, anxiety, substance use, borderline personality features and the effects of stimulants or steroids. A negative screen can also miss bipolar II or symptoms someone doesn’t recall clearly. That’s why screening leads to a clinical interview that explores timing, duration, sleep, functioning, family history and how mood episodes have unfolded over years. The questionnaire opens the conversation, and the history decides the diagnosis. Our guides on the PHQ-9 and bipolar screening and the bipolar depression diagnostic interview cover related topics.
Bipolar screening for New York patients
Screening forms can be completed online before a secure video evaluation. Visits run by secure video anywhere in New York, while you’re physically in the state. The practice is in-network with Aetna and Cigna; confirm your New York plan with the office, and see self-pay fees on the Good Faith Estimate page.
Answering honestly
It can be tempting to downplay highs, especially if they felt good or led to embarrassing choices. Answer based on what actually happened, not on how you wish it had gone. There are no right or wrong answers, and the form is a tool for understanding, not judgment. If an item is confusing or you’re unsure whether something counts, note it and bring it to your visit. Clinicians are used to sorting through uncertain memories and partial episodes.
When to seek an evaluation
Seek an evaluation if you screen positive on the MDQ, if you’ve had periods of unusual energy or little need for sleep, or if depression keeps returning or hasn’t improved with antidepressants. A family history of bipolar disorder is another reason to look closer. If you’re having thoughts of suicide, call or text 988 right away. Bipolar disorder is treatable, and an accurate diagnosis is the first step.
The Bottom Line
MDQ Scoring and the HCL-32 is common and treatable, and careful care can make daily life feel more manageable.
Frequently Asked Questions
What does a positive MDQ mean?
A positive MDQ means bipolar disorder is possible and deserves a full evaluation. The screen is positive only with yes to 7 or more of 13 symptom items, several happening during the same period, and a moderate or serious problem. It isn't a diagnosis. Other conditions can produce similar answers. A clinical interview decides.
Can the MDQ miss bipolar II disorder?
Yes, the University of Washington's scoring summary notes the MDQ is better at detecting bipolar I than bipolar II. Hypomania in bipolar II is milder and often remembered as a good stretch. A negative MDQ doesn't fully rule out bipolar disorder. Recurrent depression or poor antidepressant response deserves a closer look. Tools aimed at hypomania can help.
What is the HCL-32?
The HCL-32, or Hypomania Checklist, is a 32-item questionnaire built to pick up hypomania. It asks about periods of more energy, confidence, activity or less need for sleep. It helps surface highs people may not think of as illness. Like the MDQ, it's a screening tool. A clinical interview confirms the diagnosis.
Should a family member help with bipolar screening?
With your permission, a partner, parent or close friend can add valuable information. People in depression often don't recall earlier highs clearly. Someone close may remember periods of little sleep or unusual spending. Combining both views gives a more accurate picture. It's your choice who to include.
Why does screening for bipolar matter before treating depression?
Bipolar depression is treated differently from unipolar depression. Antidepressants taken alone can sometimes trigger mania or rapid cycling in people with bipolar disorder. Several medications are approved specifically for bipolar depression. Screening helps match treatment to the condition. It can prevent years of treatment that doesn't fit.
Can I complete bipolar screening before a video visit in New York?
Yes, screening forms like the MDQ can be completed online before a secure video evaluation anywhere in New York. Your clinician reviews the results with you during the visit. You need to be physically in New York during the visit itself. Screening is followed by a full interview. Bring any questions about items that felt unclear.
Where to go from here
- Right now, if you're not safe
- Call or text 988, or call 911.
- If you'd like an evaluation
- See how scheduling and telehealth work on the new patient page.
- If you want to keep reading
- Return to our New York bipolar depression guide for more guides. For more help preparing and finding care, see NIMH’s tips for talking with your health care provider and FindTreatment.gov.
How We Reviewed This Page
Written by Steven Lockhart of Health Marketing Group and clinically reviewed by Gabriella I. Farkas, MD PhD, a board-certified psychiatrist. Clinical information comes from the sources listed below, and the page is reviewed every 180 days or when guidance changes.
What’s new: September 29, 2026. Page published.
References
- University of Washington Psychiatry. The Mood Disorder Questionnaire (MDQ) overview and scoring. https://pcl.psychiatry.uw.edu/wp-content/uploads/2021/12/MDQ.pdf
- National Institute of Mental Health. Bipolar Disorder statistics. https://www.nimh.nih.gov/health/statistics/bipolar-disorder
- 988 Suicide & Crisis Lifeline. https://988lifeline.org/
- Tips for talking with your health care provider. https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider
- FindTreatment.gov. https://findtreatment.gov/