What the MFQ Screens For
The Mood and Feelings Questionnaire (MFQ) is a screening instrument designed to detect clinical depression (major depressive disorder and minor depression) in children and adolescents. 1, 2
Primary Purpose and Target Population
The MFQ was specifically developed to identify depressive symptoms and disorders in youth populations, with validated use primarily in adolescents aged 12-18 years. 3 The instrument exists in both:
- Full version (MFQ): 33 items assessing depressive symptoms 4
- Short version (SMFQ): 13 items providing equivalent screening efficiency 4
- Both self-report (child/adolescent) and parent-report versions are available 1, 5
What Depression Symptoms It Detects
The MFQ assesses the core symptom domains of depression, with cognitive symptoms (such as feelings of worthlessness, guilt, and hopelessness) being the strongest predictors of depression, while vegetative symptoms (sleep, appetite changes) show lower correlation with diagnosis. 2, 5
The questionnaire can distinguish:
- Major depressive disorder from non-depressed cases 1, 2
- Minor depression (less severe episodic illness) 2
- Depressed children from those with other psychiatric diagnoses including anxiety disorders, oppositional defiant disorder, conduct disorder, and ADHD 1
Performance Characteristics
In Adolescents (Ages 12-18):
- Parent-rated MFQ (MFQ-P) shows sensitivity of 0.75-0.86 and specificity of 0.73-0.87 for detecting depression 1
- Self-rated MFQ (MFQ-C) demonstrates sensitivity of 0.60-0.75 and specificity of 0.61-0.74 1
- The SMFQ performs roughly equivalent to the full MFQ, making it sufficient for screening purposes 4
- Gender-specific cut-offs are essential: For SMFQ self-report, optimal cut-offs are ≥17 for girls versus ≥6 for boys 4
In Children (Ages 11 and Younger):
- The MFQ cannot reliably discriminate depression in children below age 13, whether completed by the child or parent 4
- This aligns with USPSTF guidance that evidence for depression screening in children aged 11 years or younger is insufficient 3
Critical Clinical Considerations
High agreement exists between parent and child ratings, though parents tend to underreport depressive symptoms compared to their offspring's self-reports. 2, 5 Girls consistently report more depressive symptoms than boys, and adolescent girls aged 13-17 show the highest rates of depression (up to 53.3% in clinical samples). 5, 4
Common Pitfalls to Avoid:
- Do not use the MFQ as a diagnostic tool—positive screens require full diagnostic interview using DSM criteria to confirm depression 3
- Do not apply adult cut-offs to pediatric populations—gender and age-specific thresholds are necessary 4
- Do not screen children under age 12 with the MFQ, as it lacks discriminatory ability in this age group 4
- Pay attention to "sometimes" responses—even intermediate endorsements can signal depressive symptoms, particularly in younger children 6
Integration with Current Guidelines
The USPSTF recommends screening for major depressive disorder in adolescents aged 12-18 years, noting that while the PHQ-A and Beck Depression Inventory are most studied, the MFQ represents a validated alternative. 3 Any depression screening should only occur in practices with systems ensuring accurate diagnosis, effective treatment, and careful follow-up. 3
The MFQ has been extensively used in research examining gene-environment interactions and depression outcomes in youth, demonstrating its utility beyond simple screening. 3