The mood spectrum approach hypothesizes that a unitary and continuous approach to the assessment of both manic-hypomanic and depressive symptoms, coupled with the longitudinal, lifetime perspective offered by changes in management of these disorders, might better conform to clinical reality and lead to more refined approaches to treatment. The instruments allow for the simultaneous assessment of both overt and subtle components of depression and mania along a continuum of diverse psychopathological dimensions, different levels of mood dysregulations. The MOODS instruments focus on the presence of manic and depressive symptoms, traits, and lifestyles that characterize the ‘temperamental’ affective dysregulations that make up both fully syndromal and sub-threshold mood disturbance.

The instruments were developed by enumerating the criterion symptoms for major depression and bipolar disorders according to DSM, then adding associated features as described in the DSM, followed by atypical manifestations and temperamental features that had been observed in the clinical practice and research experience with mood disorders patients.

Two exploratory factor analyses were carried out to examine the structure of the depressive and the manic-hypomanic components of the MOODS-SR. In the first analysis of the 74 items of the depressive component, six factors were identified using a tetrachoric correlation matrix and varimax (orthogonal) rotation. These factors included depressive mood, psychomotor retardation, suicidality, drug/illness related depression, psychotic spectrum features, neurovegetative symptoms. In the second analysis of the 68 manic-hypomanic component, 9 factors were derived using the same analytical strategy. These factors included psychomotor activation, creativity, mixed instability, sociability/extraversion, spirituality/mysticism/psychoticism, mixed irritability, inflated self-esteem, euphoria, wastefilness/recklessness.

The algorithm for calculating the scores of the factors is listed below.

Scoring

Each of the MOODS instruments consists of 161 items coded as present or absent for one or more periods of at least 3-5 days through the subject’s lifetime or over the past week or month. The impairment items 28, 57, 67, 80, 108, 131, 161 are not scored. See algorithm section, below on this page for how to score the factors.

Psychometric Properties

Fagiolini A, Dell’Osso L, Pini S, Armani A, Bouanani S, Rucci P, Cassano GB, Endicott J, Maser J, Shear MK, Grochocinski VJ, Frank E: Validity and reliability of a new instrument for assessing mood symptomatology: the Structured Clinical Interview for Mood Spectrum (SCI MOODS). Int J Meth Psych Res 8:71-81, 1999.

Dell’Osso L, Armani A, Rucci P, Frank E, Fagiolini A, Corretti G, Shear MK, Grochocinski VJ, Maser JD, Endicott J, Cassano GB: Measuring mood spectrum disorder: Comparison of interview (SCI-MOODS) and self-report (MOODS-SR) instruments. Compr Psychiatry, 43:69 73, 2002.

Cassano GB, Benvenuti A, Miniati M, Calugi S, Mula M, Maggi L, Rucci P, Fagiolini A, Perris F, Frank E. The factor structure of lifetime depressive spectrum in patients with unipolar depression. J Affect Disord. 2009 May;115(1-2):87-99.

Cassano GB, Mula M, Rucci P, Miniati M, Frank E, Kupfer DJ, Oppo A, Calugi S, Maggi L, Gibbons R, Fagiolini A. The structure of lifetime manic-hypomanic spectrum. J Affect Disord. 2009 Jan;112(1-3):59-70.

Note: each items is scored as "0" (NO), "1" (YES). The impairment items 28, 57, 67, 80, 108, 131, 161 are not scored. Items with multiple responses are coded "1" if at least one of the responses is endorsed positively and "0" elsewhere.
(1) moods	mood depressive	sum of items 1 - 27
	mood manic	sum of items 29 - 56
(2) energy	energy depressive	sum of items 58 - 66
	energy manic	sum of items 68 - 79
(3) cognition	cognition depressive	sum of items 81 - 107
	cognition manic	sum of items 109 - 130
(4) rhytmicity	sum of items 132 - 160
Total score (sum of domains scores): range 0 - 154 Threshold for total score for any of the instruments: none determined at this time