Bipolar Spectrum Diagnostic Scale (BSDS)

20 question screener for bipolar spectrum diagnosis


1.Some individuals noticed that their mood and/or energy levels shift drastically from time to time
2.These individuals notice that, at times, they are moody and/or energy level is very low, and at other times, and very high
3.During their “low” phases, these individuals often feel a lack of energy, a need to stay in bed or get extra sleep, and little or no motivation to do things they need to do
4.They often put on weight during these periods
5.During their low phases, these individuals often feel “blue,” sad all the time, or depressed
6.Sometimes, during the low phases, they feel helpless or even suicidal
7.Their ability to function at work or socially is impaired
8.Typically, the low phases last for a few weeks, but sometimes they last only a few days
9.Individuals with this type of pattern may experience a period of “normal” mood in between mood swings, during which their mood and energy level feels “right” and their ability to function is not disturbed
10.They may then noticed they marked shift or “switch” in the way they feel
11.Their energy increases above what is normal for them, and they often get many things done they would not ordinarily be able to do
12.Sometimes during those “high” periods, these individuals feel as if they had too much energy or feel “hyper”
13.Some individuals, during these high periods, may feel irritable, “on edge,” or aggressive
14.Some individuals, during the high periods, take on too many activities at once
15.During the high periods, some individuals may spend money in ways that cause them trouble
16.They may be more talkative, outgoing or sexual during these periods
17.Sometimes, their behavior during the high periods seems strange or annoying to others
18.Sometimes, these individuals get into difficulty with co-workers or police during these high periods
19.Sometimes, they increase their alcohol or nonprescription drug use during the high periods
20.Now that you have read this passage, please check one of the following four options


The Bipolar Spectrum Diagnostic Scale (BSDS) was created by Ronald Pies, in the spirit of a descriptive story that captures subtle features of bipolar spectrum disorders. Its unusual as it’s a descriptive story of one’s life and it was designed to be particularly sensitive to the milder variants of bipolar disorder in outpatients. Two of the other authors subsequently revised it, resulting in splitting it into two parts. The first part is a paragraph containing 19 positively valenced sentences describing many of the symptoms of bipolar disorder. The second part of the BSDS is one simple multiple choice question, asking patients’ to rate how well the story describes their overall experience.

In the initial validation study of the BSDS, the sensitivity of the scale was approximately equal for bipolar I disorder (75%) and bipolar II ⁄ NOS (79%). The overall sensitivity for bipolar types I, II, NOS: 76% and a overall specificity of 85%. In a large sample of psychiatric outpatients we found that the BSDS could achieve adequate sensitivity as a screening instrument (i.e.,90%) when the threshold was lowered to a cutoff of 8, though at this cutoff the specificity of the scale was only 51% and positive predictive value was only 16%.

The scale is ideal for screening, but not diagnosis as it does not inherently meet the full criterion for a DSM V Bipolar and Related Disorders. There is limited evidence that it can be used to monitor treatment progress. Multiple studies have identified various cutoff scores with clinically useful sensitivity and specificity values over multiple studies in various countries. In general its good at ruling out a diagnosis of bipolar disorder; however some studies have shown a low positive predictive value which indicates that it is not good at ruling in the diagnosis.


Nassir ghaemi S, Miller CJ, Berv DA, Klugman J, Rosenquist KJ, Pies RW.

Journal of Affective Disorders 2005, 84 (2): 273-7

Zimmerman M, Galione JN, Chelminski I, Young D, Ruggero CJ.

Bipolar Disorders 2010, 12 (5): 528-38

Carvalho AF, Takwoingi Y, Sales PM, et al.

Journal of Affective Disorders 2015 February 1, 172: 337-46

The Bipolar Spectrum Diagnostic Scale (BSDS) calculator is created by QxMD.

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1. Some individuals noticed that their mood and/or energy levels shift drastically from time to time

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