To evaluate the “Mini International Neuropsychiatric Interview (MINI)” used by family resident physicians in primary health care (PHC) in Brazil.

Training for administrating the MINI was given as part of a broad psychiatry education program, and was performed in PHC consultations. Interviews were held with 120 PHC patients. MINI was administered by 25 physicians, while the “Structured Clinical Interview for Diagnosis (SCID-I)” was administered by a psychiatrist. The physicians answered questions on the applicability of the MINI.

Concordance levels for the following diagnoses were analyzed: any mental disorder; depressive disorders in general, major depressive episode and dysthymia; anxiety disorders in general, generalized anxiety disorder and panic disorder; and substance abuse disorders. Kappa coefficients ranged between 0.65 and 0.85; sensitivity between 0.75 and 0.92; specificity, between 0.90 and 0.99; positive predictive values (PPV) between 0.60 and 0.86; negative predictive values (NPV) between 0.92 and 0.99; and accuracy between 0.88 and 0.98. The physicians considered MINI comprehensibility and clinical relevance satisfactory; the brevity of its administration was considered satisfactory for use with previous screening only.

These good results may be related with more frequent, intensive, and diversified training in psychiatry. The MINI is a useful tool for general practitioners and should be part of the broad psychiatry education program offered to these professionals.

the Mini International Neuropsychiatric Interview (MINI) is a short diagnostic structured interview (DSI) designed to generate positive diagnosis for the main Diagnostic and Statistical Manual (DSM)-III-R/IV Axis I disorders and to explore the symptoms of Criterion A for Schizophrenia (Sc) to rule out the presence of Psychotic Disorders. The procedural validity of the MINI was investigated in psychiatric patients using the Composite International Diagnostic Interview (CIDI) as a gold standard in Europe and the Structured Clinical Interview for DSM-III-R (SCID-P)in the US. This paper presents the concordance and the reasons for discordance between the MINI and the CIDI for DSM-III-R Psychotic and Mood Disorders. No study had systematically analysed the sources of disagreement between DSI based on the same operational criteria in psychotic patients.

256 consecutively recruited psychiatric patients and 50 non-psychiatric subjects passed the MINI and the CIDI.

concordance was good for the presence of Major Depressive Episode (MDE), Manic Episode, Psychotic Disorders, syndromes or symptoms (0.65 to 0.82). Inconsistencies in evaluation of the disorder recency accounted for 25 to 40% of discordance for current diagnoses. Fifty-three percent of discordance for lifetime Manic Episode resulted from inconsistencies in the severity of the index episode. Fifty percent of discordance for the diagnosis of Psychotic Disorders was due to algorithmic differences between the two DSI.

the MINI yields reliable DSM-III-R diagnoses within a short time frame (22 minutes). Depending on the quantitative and the qualitative analyses of discrepancies between the MINI and the CIDI for Psychotic Disorders and Mood Episodes, we proposed and tested modifications leading to improvements in both interviews. The procedural validity of the modified MINI according to the modified CIDI was found to be very good.

To assess the feasibility, patient and clinician acceptability and test-retest reliability of the Mini-International Neuropsychiatric Interview (MINI) used by non-psychiatrists in an acute psychiatric ward.

Of 268 consecutive patients included in a cross-sectional study, 176 (66%) completed MINI, and were compared to patients not interviewed. Patients and clinicians were questioned about the interview, using Visual Analogue Scales (VAS). For 38 patients, test-retest reliability was assessed with Cohen's kappa and observed agreement.

MINI was not feasible for all patients. Among factors associated with not being interviewed were early discharge, psychosis, substance use and involuntary admissions. Although evaluations by patients and clinicians completing the postinterview questionnaire varied, MINI was generally perceived as being useful and feasible. Psychotic symptoms were associated with a less positive experience with MINI for both patients and clinicians. In the test-retest analyses, kappa values indicated excellent agreement for six diagnoses, fair to good for six and poor for seven, whereas observed agreement was 75% or above for all disorders.

Among patients admitted to an acute psychiatric ward willing and able to complete the interview, MINI was well accepted by patients and clinicians, and has moderately good test-retest reliability.

Clinical diagnosis has been shown to be unreliable compared to structured diagnostic schedules. However, clinicians rarely use structured diagnostic schedules due to concerns about the feasibility in clinical practice and about patient acceptance. Mini International Neuropsychiatric Schedule is a short diagnostic instrument validated against SCID and CIDI but its feasibility and patient acceptance has not been studied.

One hundred and eleven patients admitted to a partial program were administered Mini International Neuropsychiatric Schedule and the interview was timed. A short questionnaire was administered to assess patients’ views about the interview. For a subgroup of patients, diagnoses by both open interviews and Mini International Neuropsychiatric Interview (MINI) were available. These were compared to look for agreement in primary diagnoses and co-morbid conditions.

MINI took an average of 16.4 min to administer. Patients’ views of MINI were positive. It was considered comprehensive enough to cover all patient symptoms and at the same time not unduly lengthy. Patients were not bothered by the interview format. There was disagreement between MINI primary diagnosis and open diagnosis in 42% cases. In 33% the disagreement was of substantial clinical significance. MINI diagnosed more co-morbid conditions (average 2.05 compared to 0.5 in open interview).

MINI is a short diagnostic interview schedule that can be easily incorporated into routine clinical interviews. It has good acceptance by patients.

Se ha mostrado que el diagnóstico clínico es poco fiable comparado con los inventarios diagnósticos estructurados. Sin embargo, los profesionales clínicos utilizan con poca frecuencia los inventarios diagnósticos debido a preocupaciones sobre la viabilidad en la práctica clínica y sobre la aceptación por los pacientes. El Mini Inventario Neuropsiquiátrico Internacional es un instrumento diagnóstico breve validado frente a la SCID y la CIDI, pero su viabilidad y aceptación por los pacientes no se ha estudiado.

Se administró el Mini Inventario Neuropsiquiátrico Internacional a 111 í pacientes admitidos en un programa parcial y se cronometró la entrevista. Se administró un cuestionario breve para evaluar las opiniones de los pacientes sobre la entrevista. Para un subgrupo de pacientes, se dispuso de diagnósticos tanto por entrevistas abiertas como por la Mini Entrevista Neuropsiquiátrica Internacional (MINI). Se compararon para buscar acuerdo en los diagnósticos primarios y los trastornos comórbidos.

Administrar la MINI llevó una media de 16,4 minutos. Las opiniones de los pacientes de la MINI fueron positivas. Se consideró lo bastante amplia para cubrir todos los síntomas de los pacientes y, al mismo tiempo, no indebidamente larga. A los pacientes no les molestó el formato de entrevista. Hubo desacuerdo entre el diagnóstico primario de la MINI y el diagnóstico abierto en el 42% de los casos. En un 33%, el desacuerdo era de significación clínica sustancial. La MINI diagnosticó más trastornos comórbidos (media 2,05 comparado con 0,5 en la entrevista abierta).

La MINI es un inventario de entrevista diagnóstica que se puede incorporar fácilmente a las entrevistas clínicas habituales. Tiene buena aceptación por los pacientes.