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      Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI)

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          Abstract

          Background

          There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI).

          Methods

          The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen’s kappa and “observed agreement”.

          Results

          There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and “observed agreement” was above 88%.

          Conclusion

          The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language.

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          Most cited references16

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          Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.

          This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.
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            MINI International Neuropsychiatric Schedule: clinical utility and patient acceptance.

            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.
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              Validity and applicability of the Mini International Neuropsychiatric Interview administered by family medicine residents in primary health care in Brazil.

              To evaluate the validity and applicability of the Mini International Neuropsychiatric Interview (MINI) used by family medicine residents in primary health care (PHC) in Brazil. Training for administrating the MINI was given as part of a broad psychiatry education program. Interviews were held with 120 PHC patients who were at least 15 years old. MINI was administered by 25 resident physicians, while the Structured Clinical Interview for Diagnosis (SCID) was administered by a psychiatrist blind to patients' results on the MINI, and the diagnoses on both interviews were compared. The resident physicians answered questions on the applicability of the MINI. Concordance levels for any mental disorder, the broader current diagnostic categories and the most common specific diagnoses were analyzed. 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 resident physicians considered MINI comprehensibility and clinical relevance satisfactory. These good psychometric results in a real-world setting may be related to a special training program, which is more frequent, intensive and diversified. In these conditions, the MINI is a useful tool for general practitioners.
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                Author and article information

                Contributors
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central
                1471-244X
                2014
                22 May 2014
                : 14
                : 148
                Affiliations
                [1 ]Division of Mental Health and Addiction, National Centre for Hearing Impairment and Mental Health, Oslo University Hospital, Oslo, Norway
                [2 ]Department of Psychology, University of Oslo, Oslo, Norway
                [3 ]Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
                [4 ]Institute of Clinical Medicine, University of Oslo, Oslo, Norway
                Article
                1471-244X-14-148
                10.1186/1471-244X-14-148
                4060880
                24886297
                13bc1f60-8b72-4b44-9de1-bb2a7d90ed8c
                Copyright © 2014 Øhre et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 September 2013
                : 9 May 2014
                Categories
                Research Article

                Clinical Psychology & Psychiatry
                mini,mental disorders,psychiatric diagnoses,assessment,deafness,hearing loss,sign language,psychometrics

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