Mauro Giovanni Carta1, Andrea Norcini-Pala2, Maria Francesca Moro3, Matteo Balestrieri4, Filippo Caraci5, Liliana Dell'Osso6, Guido Di Sciascio7, Carlo Faravelli8, Maria Carolina Hardoy9, Eugenio Aguglia5, Rita Roncone10, Antonio Egidio Nardi11, Filippo Drago5. 1. Mailman School of Public Health, Columbia University, New York, NY, USA. Electronic address: mgcarta@tiscali.it. 2. Mailman School of Public Health, Columbia University, New York, NY, USA. 3. Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. 4. DISM, University of Udine, Udine, Italy. 5. Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy. 6. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Institute of Psychiatry, University of Rio de Janeiro, Rio de Janeiro, Brazil. 7. Department of Psychiatry, Policlinico Hospital, Bari, Italy. 8. Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, Firenze, Italy. 9. Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. 10. Department of Health, Life and Environmental Sciences, Unit of Psychiatry, University of L'Aquila, L'Aquila, Italy. 11. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Abstract
OBJECTIVE: It is debated whether the Mood Disorder Questionnaire (MDQ) can generate false positives by screening other disorders as bipolar, or identify sub-threshold bipolarity. The aim is to verify if Quality of Life (QoL) impairment in MQD positives in the community is due to MDQ positivity itself, or to psychiatric diagnosis associated with MDQ positivity (supporting the former hypothesis). METHOD: Community survey. Sample randomized after stratification of the adult population in the records of seven Italian regions. TOOLS: MDQ; Short Form Health Survey (SF-12); semi-structured clinical interview carried out by clinicians. RESULTS: Positives at MDQ show worsening QoL with an attributable burden of 2.8 ± 1.8 lower than in MDD (5.6 ± 3.6, p < 0.001) or Eating Disorders (4.4 ± 6.6, p < 0.03) and similar to Panic Disorder (2.9 ± 0.9, p = 0.44). The burden is lower in the middle-aged (25-59 years) than in the young (18-24) (4.65 ± 4.5 vs 2.58 ± 2.0, p=0.007) or in the elderly (≥60) (4.12 ± 3.2; p = 0.024). In the elderly the burden is independent from comorbid psychiatric disorders. LIMITATIONS: This is a preliminary study based on one survey not designed to test this specific hypothesis, thus its results have a heuristic value only. CONCLUSIONS: The worsening of QoL due to positivity at MDQ is largely independent from comorbid conditions, supporting the hypothesis that MDQ positivity identifies a specific area of suffering that is "subthreshold" to the psychiatric diagnosis, and relevant for public health.
OBJECTIVE: It is debated whether the Mood Disorder Questionnaire (MDQ) can generate false positives by screening other disorders as bipolar, or identify sub-threshold bipolarity. The aim is to verify if Quality of Life (QoL) impairment in MQD positives in the community is due to MDQ positivity itself, or to psychiatric diagnosis associated with MDQ positivity (supporting the former hypothesis). METHOD: Community survey. Sample randomized after stratification of the adult population in the records of seven Italian regions. TOOLS: MDQ; Short Form Health Survey (SF-12); semi-structured clinical interview carried out by clinicians. RESULTS: Positives at MDQ show worsening QoL with an attributable burden of 2.8 ± 1.8 lower than in MDD (5.6 ± 3.6, p < 0.001) or Eating Disorders (4.4 ± 6.6, p < 0.03) and similar to Panic Disorder (2.9 ± 0.9, p = 0.44). The burden is lower in the middle-aged (25-59 years) than in the young (18-24) (4.65 ± 4.5 vs 2.58 ± 2.0, p=0.007) or in the elderly (≥60) (4.12 ± 3.2; p = 0.024). In the elderly the burden is independent from comorbid psychiatric disorders. LIMITATIONS: This is a preliminary study based on one survey not designed to test this specific hypothesis, thus its results have a heuristic value only. CONCLUSIONS: The worsening of QoL due to positivity at MDQ is largely independent from comorbid conditions, supporting the hypothesis that MDQ positivity identifies a specific area of suffering that is "subthreshold" to the psychiatric diagnosis, and relevant for public health.