Open Access Research article

Using the mood disorder questionnaire and bipolar spectrum diagnostic scale to detect bipolar disorder and borderline personality disorder among eating disorder patients

Toshihiko Nagata1*, Hisashi Yamada2, Alan R Teo3, Chiho Yoshimura2, Yuya Kodama1 and Irene van Vliet4

Author Affiliations

1 Department of Neuropsychiatry, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abunoku, Osaka 545-8585, Japan

2 Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Japan

3 Department of Internal Medicine and Department of Psychiatry, University of Michigan, Ann Arbor, USA

4 Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands

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BMC Psychiatry 2013, 13:69  doi:10.1186/1471-244X-13-69

Published: 25 February 2013



Screening scales for bipolar disorder including the Mood Disorder Questionnaire (MDQ) and Bipolar Spectrum Diagnostic Scale (BSDS) have been plagued by high false positive rates confounded by presence of borderline personality disorder. This study examined the accuracy of these scales for detecting bipolar disorder among patients referred for eating disorders and explored the possibility of simultaneous assessment of co-morbid borderline personality disorder.


Participants were 78 consecutive female patients who were referred for evaluation of an eating disorder. All participants completed the mood and eating disorder sections of the SCID-I/P and the borderline personality disorder section of the SCID-II, in addition to the MDQ and BSDS. Predictive validity of the MDQ and BSDS was evaluated by Receiver Operating Characteristic analysis of the Area Under the Curve (AUC).


Fifteen (19%) and twelve (15%) patients fulfilled criteria for bipolar II disorder and borderline personality disorder, respectively. The AUCs for bipolar II disorder were 0.78 (MDQ) and 0.78 (BDSD), and the AUCs for borderline personality disorder were 0.75 (MDQ) and 0.79 (BSDS).


Among patients being evaluated for eating disorders, the MDQ and BSDS show promise as screening questionnaires for both bipolar disorder and borderline personality disorder.

Bipolar disorder; Borderline personality disorder; Eating disorder; Comorbidity; Screening scale