Screening for bipolar disorder in a county jail at the time of criminal arrest

David E. Kemp, Robert M A Hirschfeld, Stephen J. Ganocy, Omar Elhaj, Renee Slembarski, Sarah Bilali, Carla Conroy, James Pontau, Robert L. Findling, Joseph R. Calabrese

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective: This study assessed the operating characteristics of the mood disorder questionnaire (MDQ) among offenders arrested and detained at a county jail. Method: The MDQ, a brief self-report instrument designed to screen for all subtypes of bipolar disorder (BP I, II and NOS) was voluntarily administered to adult detainees at the Ottawa County Jail in Port Clinton, Ohio. A confirmatory diagnostic evaluation was also performed using the mini-international neuropsychiatric interview (MINI). The MDQ was scored using a standard algorithm requiring endorsement of 7/13 mood items as well as two items that assess whether manic or hypomanic symptoms co-occur and cause moderate to severe functional impairment. In addition to the standard algorithm for scoring the MDQ, modifications were also tested in an attempt to improve overall sensitivity. Results: Among 526 jail detainees who completed the MDQ, 37 (7%) screened positive for bipolar disorder. Of 164 detainees who agreed to a research diagnostic evaluation, 32 (19.5%) screened positive on the MDQ, while 55 (33.5%) met criteria for bipolar disorder according to the MINI. When administered to the sample of 164 adult jail detainees, the sensitivity of the MDQ was 0.47 and the specificity was 0.94. The MDQ was significantly better at detecting BP I (0.59) than BP II/NOS (0.19; p = 0.008). Modification of scoring the MDQ improved the sensitivity for detection of BP II from 0.23 to 0.54 with minimal decrease in specificity (0.84). The optimum sensitivity and specificity of the MDQ was achieved by decreasing the item threshold to 3/13 and eliminating the symptom co-occurrence and functional impairment items. Conclusion: The MDQ was found to have limited utility as a screening tool for bipolar disorder in a correctional setting, particularly for the BP II subtype.

Original languageEnglish (US)
Pages (from-to)778-786
Number of pages9
JournalJournal of Psychiatric Research
Volume42
Issue number9
DOIs
StatePublished - Jul 2008

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Mood Disorders
Bipolar Disorder
Surveys and Questionnaires
Self Report
Interviews
Sensitivity and Specificity

Keywords

  • Bipolar disorder
  • Bipolar II
  • Jail
  • Mood disorder questionnaire
  • Psychometrics
  • Screening

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Psychology(all)

Cite this

Kemp, D. E., Hirschfeld, R. M. A., Ganocy, S. J., Elhaj, O., Slembarski, R., Bilali, S., ... Calabrese, J. R. (2008). Screening for bipolar disorder in a county jail at the time of criminal arrest. Journal of Psychiatric Research, 42(9), 778-786. https://doi.org/10.1016/j.jpsychires.2007.08.001

Screening for bipolar disorder in a county jail at the time of criminal arrest. / Kemp, David E.; Hirschfeld, Robert M A; Ganocy, Stephen J.; Elhaj, Omar; Slembarski, Renee; Bilali, Sarah; Conroy, Carla; Pontau, James; Findling, Robert L.; Calabrese, Joseph R.

In: Journal of Psychiatric Research, Vol. 42, No. 9, 07.2008, p. 778-786.

Research output: Contribution to journalArticle

Kemp, DE, Hirschfeld, RMA, Ganocy, SJ, Elhaj, O, Slembarski, R, Bilali, S, Conroy, C, Pontau, J, Findling, RL & Calabrese, JR 2008, 'Screening for bipolar disorder in a county jail at the time of criminal arrest', Journal of Psychiatric Research, vol. 42, no. 9, pp. 778-786. https://doi.org/10.1016/j.jpsychires.2007.08.001
Kemp, David E. ; Hirschfeld, Robert M A ; Ganocy, Stephen J. ; Elhaj, Omar ; Slembarski, Renee ; Bilali, Sarah ; Conroy, Carla ; Pontau, James ; Findling, Robert L. ; Calabrese, Joseph R. / Screening for bipolar disorder in a county jail at the time of criminal arrest. In: Journal of Psychiatric Research. 2008 ; Vol. 42, No. 9. pp. 778-786.
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abstract = "Objective: This study assessed the operating characteristics of the mood disorder questionnaire (MDQ) among offenders arrested and detained at a county jail. Method: The MDQ, a brief self-report instrument designed to screen for all subtypes of bipolar disorder (BP I, II and NOS) was voluntarily administered to adult detainees at the Ottawa County Jail in Port Clinton, Ohio. A confirmatory diagnostic evaluation was also performed using the mini-international neuropsychiatric interview (MINI). The MDQ was scored using a standard algorithm requiring endorsement of 7/13 mood items as well as two items that assess whether manic or hypomanic symptoms co-occur and cause moderate to severe functional impairment. In addition to the standard algorithm for scoring the MDQ, modifications were also tested in an attempt to improve overall sensitivity. Results: Among 526 jail detainees who completed the MDQ, 37 (7{\%}) screened positive for bipolar disorder. Of 164 detainees who agreed to a research diagnostic evaluation, 32 (19.5{\%}) screened positive on the MDQ, while 55 (33.5{\%}) met criteria for bipolar disorder according to the MINI. When administered to the sample of 164 adult jail detainees, the sensitivity of the MDQ was 0.47 and the specificity was 0.94. The MDQ was significantly better at detecting BP I (0.59) than BP II/NOS (0.19; p = 0.008). Modification of scoring the MDQ improved the sensitivity for detection of BP II from 0.23 to 0.54 with minimal decrease in specificity (0.84). The optimum sensitivity and specificity of the MDQ was achieved by decreasing the item threshold to 3/13 and eliminating the symptom co-occurrence and functional impairment items. Conclusion: The MDQ was found to have limited utility as a screening tool for bipolar disorder in a correctional setting, particularly for the BP II subtype.",
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AU - Hirschfeld, Robert M A

AU - Ganocy, Stephen J.

AU - Elhaj, Omar

AU - Slembarski, Renee

AU - Bilali, Sarah

AU - Conroy, Carla

AU - Pontau, James

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AU - Calabrese, Joseph R.

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