What the Mood and Feelings Questionnaire Screens For
The Mood and Feelings Questionnaire (MFQ) screens specifically for depressive symptoms and major depressive disorder in adolescents aged 12-18 years. 1
Primary Screening Purpose
The MFQ was specifically developed to identify depressive symptoms and disorders in youth populations, with validated use primarily in adolescents aged 12-18 years. 1 It detects clinical depression by assessing mood-related symptoms that align with diagnostic criteria for major depressive disorder. 2
What It Actually Measures
The MFQ evaluates the core symptom domains of depression:
- Cognitive symptoms (such as feelings of worthlessness, hopelessness, and negative self-perception) correlate most strongly with overall depression severity 3
- Mood symptoms including persistent sadness, irritability, and anhedonia 2
- Vegetative symptoms (sleep disturbance, appetite changes, fatigue) though these show weaker correlation with overall depression scores 3
Age-Specific Performance
Critical limitation: The MFQ cannot reliably discriminate depression in children below age 13. 1 Evidence demonstrates:
- In adolescents aged 13-17 years, the MFQ performs fairly to well with adequate sensitivity and specificity 4
- In children aged 6-12 years, the MFQ fails to discriminate depression whether completed by the child or parent 4
- The USPSTF states that evidence for depression screening in children aged 11 years or younger is insufficient 1
Diagnostic Accuracy
The MFQ shows reasonable screening performance when used in appropriate age groups:
- Parent-rated MFQ demonstrates sensitivity of 0.75-0.86 and specificity of 0.73-0.87 for detecting DSM depression in adolescents 2
- Self-rated MFQ shows somewhat lower specificity, with sensitivity of 0.60-0.75 and specificity of 0.61-0.74 2
- The shortened version (SMFQ with 13 items) performs roughly equivalent to the full 33-item MFQ 4
Critical Clinical Caveat
The MFQ is a screening tool only and should never be used as a diagnostic instrument. 1 All positive screens require full diagnostic interview using DSM criteria to confirm the presence of major depression or dysthymia. 5 The false positive rate is substantial—in primary care settings with 5-10% depression prevalence, approximately 60-76% of positive screens are false positives. 6, 7
Gender Differences in Screening
Girls report significantly more depressive symptoms than boys on the MFQ, requiring gender-specific cut-off scores for optimal screening performance. 4, 3 For the SMFQ in adolescents, suggested clinical cut-offs are ≥12 for girls versus ≥6 for boys. 4
When Screening Should Occur
Depression screening with the MFQ should only occur in practices with systems ensuring accurate diagnosis, effective treatment, and careful follow-up. 1 Benefits from screening are unlikely to be realized unless such systems are functioning well. 5