Abstract：
Bipolar disorder is challenging to diagnose. In Rwanda, a sub-Saharan country with a limited number of psychiatrists, the number of people with an undetected diagnosis of bipolar disorder could be high. Still, no screening tool for the disorder is available in the country. This study aimed to adapt and validate the Mood Disorder Questionnaire in the Rwandan population.
The Mood Disorder Questionnaire was translated into Kinyarwanda. The process involved back-translation, cross-cultural adaptation, field testing of the pre-final version, and final adjustments. A total of 331 patients with either bipolar disorder or unipolar major depression from two psychiatric outpatient hospitals were included. The statistical analysis included reliability and validity analyses and receiver operating characteristic curve (ROC) analysis. The optimal cut-off was chosen by maximizing Younden\'s index.
The Rwandese version of The Mood Disorder Questionnaire had adequate internal consistency (Cronbach\'s alpha =0.91). The optimal threshold value was at least six positive items, which yielded excellent sensitivity (94.7%), and specificity (97.3%). The ROC area under the curve (AUC) was 0.99.
The adapted tool showed good psychometric properties in terms of reliability and validity for the screening of bipolar disorder, with a recommended cutoff value of six items on the symptom checklist for a positive score and an exclusion of items 14 and 15. The tool has the potential to be a crucial instrument to identify otherwise undetected cases of bipolar disorder in Rwanda, improving access to mental health treatment, thus enhancing the living conditions of people with bipolar disorder.
The Mood Disorder Questionnaire was translated into Kinyarwanda. The process involved back-translation, cross-cultural adaptation, field testing of the pre-final version, and final adjustments. A total of 331 patients with either bipolar disorder or unipolar major depression from two psychiatric outpatient hospitals were included. The statistical analysis included reliability and validity analyses and receiver operating characteristic curve (ROC) analysis. The optimal cut-off was chosen by maximizing Younden\'s index.
The Rwandese version of The Mood Disorder Questionnaire had adequate internal consistency (Cronbach\'s alpha =0.91). The optimal threshold value was at least six positive items, which yielded excellent sensitivity (94.7%), and specificity (97.3%). The ROC area under the curve (AUC) was 0.99.
The adapted tool showed good psychometric properties in terms of reliability and validity for the screening of bipolar disorder, with a recommended cutoff value of six items on the symptom checklist for a positive score and an exclusion of items 14 and 15. The tool has the potential to be a crucial instrument to identify otherwise undetected cases of bipolar disorder in Rwanda, improving access to mental health treatment, thus enhancing the living conditions of people with bipolar disorder.
摘要：
背景：双相情感障碍的诊断具有挑战性。在卢旺达,一个精神科医生数量有限的撒哈拉以南国家，未被诊断为双相情感障碍的人数可能很高。尽管如此，该国没有针对该疾病的筛查工具。这项研究旨在适应和验证卢旺达人口的情绪障碍问卷。
方法：情绪障碍问卷被翻译成Kinyarwanda。该过程涉及回译，跨文化适应，预最终版本的现场测试，最后的调整。包括来自两家精神病门诊医院的331例双相情感障碍或单相抑郁症患者。统计分析包括可靠性和有效性分析以及受试者工作特征曲线（ROC）分析。通过最大化Younden指数来选择最佳截止值。
结果：Rwandese版本的情绪障碍问卷具有足够的内部一致性（Cronbach'salpha=0.91）。最佳阈值至少为6个正项目，具有出色的灵敏度（94.7%），和特异性（97.3%）。ROC曲线下面积(AUC)为0.99。
结论：适应的工具在双相情感障碍筛查的信度和效度方面显示出良好的心理测量特性，在症状检查表上建议的临界值为6个项目，以获得阳性评分，并排除项目14和15。该工具有可能成为识别卢旺达未发现的双相情感障碍病例的关键工具，改善获得心理健康治疗的机会，从而改善双相情感障碍患者的生活条件。
方法：情绪障碍问卷被翻译成Kinyarwanda。该过程涉及回译，跨文化适应，预最终版本的现场测试，最后的调整。包括来自两家精神病门诊医院的331例双相情感障碍或单相抑郁症患者。统计分析包括可靠性和有效性分析以及受试者工作特征曲线（ROC）分析。通过最大化Younden指数来选择最佳截止值。
结果：Rwandese版本的情绪障碍问卷具有足够的内部一致性（Cronbach'salpha=0.91）。最佳阈值至少为6个正项目，具有出色的灵敏度（94.7%），和特异性（97.3%）。ROC曲线下面积(AUC)为0.99。
结论：适应的工具在双相情感障碍筛查的信度和效度方面显示出良好的心理测量特性，在症状检查表上建议的临界值为6个项目，以获得阳性评分，并排除项目14和15。该工具有可能成为识别卢旺达未发现的双相情感障碍病例的关键工具，改善获得心理健康治疗的机会，从而改善双相情感障碍患者的生活条件。
