MINI INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW , ARABIC VERSION IN DIAGNOSIG IN PSYCHIATRY SIMPLY BY BOTH ICD10 AND DSMIV

1. Validity and Reliability of
MINI – Arabic
in Addiction Disorders .
Albehairy A. MD, Sadek A MD, Ghanem M. MD, Asaad T. MD,
Sheehan D.MD, Sheehan K PhD
by
Dr. Ahmed Albehairy, M.D
Psychiatry Consultant
Ministry of Health, Egypt

2. The Study Need
& Hypothesis

3. Aim of The Work

4. Aim of The Work
 Primary:
1- to examine the concordance
between the MINI-Arabic and the
CIDI –Arabic, and between the
Substance use modules in both
MINI PLUS-Arabic & CIDI –Arabic .

5. Aim of The Work ( cont.)
 Secondary :
2- To compare the administration times of
equivalent sections of the MINI-Arabic,
MINI PLUS-Arabic, and CIDI- Arabic .
3- To assess the concordance of
MINI- Arabic and CIDI- Arabic comorbid
diagnoses in patients with substance use
disorders.

6. Aim of The Work ( cont.)
 Secondary ( cont.) :
4- To assess the inter-rater and retest
reliability of the MINI-Arabic.
5- To assess the predictive value of screen
items from the long form of the patient –
rated MINI-SCREEN in establishing rated
MINI diagnoses.

7. SUBJECTS
And
METHOD

8. Subjects:
1- Patient Group:
A- Inclusion criteria.
B- Exclusion criteria.
C- Selection of cases.
2- Control Group.

9. Method:
1- Procedure.
2- Tools applied in this work .
3- Statistical analysis.

10. Procedures of the Work
TRANSLATION
TRAINING
PILOT STUDY
CLINICAL HISTORY
CLINICAL DIAGNOSIS
INFORMED CONSENT
DEMOGRAPHIC INFORMATION
MINI-SCREEN RATED BY PATIENT
MINI ADMINISTERED MINI ADMINISTERED
& TIMED BY 2ND RATER ON 20 PTS
MINI PLUS MODULE ADMINISTERED & TIMED
CIDI ADMINISTRERED & TIMED
MINI READMINISTERED IN 1-2 DAYS TO 20 PATIENTS FOR RETEST
DATA ENTRY
DATA CHECKING/EDITING
DATA ANALYSIS
STATISTICAL REPORT
FINAL THESIS WRITE UP

11. Tools Applied in This Work
1- Mini International Neuropsychiatric
Interview (MINI) 5.0, The MINI SCREEN
( long form ) and MINI-PLUS 5.0.
( sheehan etal., 1997)
2- Composite International Diagnostic
Interview (CIDI), Authorized core version
1.0. ( WHO 1990 & Karam etal.,1993).

12. Statistical Analysis
- Non parametric approach.
- Validity and reliability of MINI & MINI
PLUS modules ( by Kappa, PPV,
NPV, Specificity, Sensitivity, &
Efficiency ) .
- Hot items analysis of MINI SCREEN
( by Kappa, PPV, NPV, & Efficiency ) .

13. RESULTS
RESULT

14. Demographic Data
Variable PATIENTS DEPENDENCE AND ABUSE Control X2 Chi- Sig (P)
square
FREQ. % FREQ. %
Age 4.8 >0.05
14-20 years 25 21.2% 13 21.7%
21-40 years 84 71.2% 36 60%
41-65 years 9 7.6% 11 18.3%
Sex 2.27 >0.05
Male 113 95.8% 54 90%
Female 5 4.2% 6 10%
Religion 0.399 >0.05
Moslem 106 89.8% 52 86.7%
C. Orthodox 12 10.2% 8 13.3%
Marital Status 12.62 <0.05*
<0.05*
Never married 78 66.1% 35 58.3%
Engaged 4 3.4% 1 1.7%
Married 22 18.6% 23 38.3%
Separated 3 2.5% 1 1.7%
Divorced 10 8.5% 0 0
Widow 1 0.8% 0 0
Occupation 4 8.196 >0.05
Professional Managerial 3 2.5% 19 6.7%
Clerical 28 23.7% 1 31.7%
Skilled 5 4.2% 17 1.7%
Student 40 33.9% 7 28.3%
Unemployed 25 21.2% 11 11.7%
Retrieved 17 14.4% 1 18.3%
0 0 1.7%
Education 7 4.53 >0.05
Illiterate 6 5.1% 4 1.7%
1ry school 8 6.8% 8 6.7%
Preparatory 14 11.9% 4 13.3%
2ry 15 12.7% 14 6.7%

15. Validity of MINI
CONCORDANC - + Kappa Sensitivity specificity NPV ppv Efficiency
E RATINGS TN FN
FP TP
CURRENT 155 3 0.83 0.83 O.97 O.97 0.83 O.96
ALC.DEP. IN 3 17
MINI & CIDI
DSM-III
N= 178
CURRENT 153 3 0.73 0.82 O.97 O.98 O.75 O.94
ALC.DEP. IN
MINI & CIDI
ICD-10 5 17
LIFE TIME ALC. 93 8 O.55 O.86 O.73 O.93 O.57 O.77
DEP. IN MINI &
CIDI DSM-III 30 47
LIFE TIME ALC. 89 8 O.5 O.87 O.71 O.92 O.57 O.76
DEP. IN MINI &
CIDI-ICD10 34 47
CURRENT 71 3 O.73 O.96 O.83 O.95 O.86 O.73
DRUG DEP. IN
MINI & CIDI 14 90
DSM-III

16. Validity of MINI
( CONT.)
CONCORDANC - + Kappa Sensitivity specificity NPV ppv Efficiency
E RATINGS TN FN
FP TP
LIFE TIME 55 11 0.71 0.9 0.79 0.83 0.83 0.86
DRUG
DEPENDENCE 15 97
IN MINI & CIDI
ICD-10
CURRENT 167 0 0.9 1 0.98 0.94 0.83 0.99
DRUG ABUSE
IN MINI & CIDI 2 9
DSMIII
CURRENT 164 0 0.62 1 0.97 1 0.63 0.95
DRUG ABUSE
IN MINI AND 5 9
CIDI ICD-10
LIFE TIME 163 0 0.86 1 0.98 1 0.75 0.98
DRUG ABUSE
IN MINI & CIDI 4 11
DSMII
LIFE TIME 159 0 0.76 1 0.96 1 0.64 0.96
DRUG ABUSE
IN MINI AND 8 11
CIDI ICD-10

17. Validity of MINI
( CONT.)
CONCORDANC - + Kappa Sensitivity specificity NPV ppv Efficiency
E RATINGS TN FN
FP TP
COMORBID 99 1 0.84 0.97 O.88 O.98 0.84 O.92
DIAG IN MINI &
CIDI DSMIII 12 65
COMORBID 101 1 0.82 0.97 O.88 O.98 O.81 O.91
DIAG IN MINI &
CIDI ICD 10 14 62
ALC & DRUG 56 5 O.87 O.95 O.91 O.91 O.95 O.94
USE IN MINI &
CLINICAL 5 112
IMPRESSION
COMORBID 99 4 O.77 O.94 O.9 O.97 O.79 O.89
DIAG IN MINI &
CLINICAL 16 59
IMPRESSION

18. RELIABILTY OF MINI
Diagnoses ( n=118) Inter- rater Retest
(Kappa) (Kappa)
MINI 0.89 0.93
MINI PLUS ( ALCOHOL & 0.91 0.98
DRUG CURRENT)
MINI PLUS ( ALCOHOL & 0.94 0.89
DRUG LIFE TIME )
MINI PLUS ( COMORBID 0.85 0.84
PSYCHIATRIC
DISORDERS)

19. Time duration of diagnostic interviews
In Minutes Mean S.D Median Min Max
(in Min.)
MINI 14.65 ±2.19 14 11 22
MINI Plus 18.94 ±3.73 18 14 32
CIDI 45.08 ±6.09 42 24 65
MINI Plus Alcohol & Drug Module 12.29 ±2.2 12 9 24
CIDI Alcohol & Drug Module 23.75 ±4.11 23.5 18 56
MINI Control 7 ±0.49 7 5 9
MINI Plus Control 12.00 ±1.67 12 10 15
CIDI Control 24.6 ±3.16 24 21 29
MINI Retest 14.6 ±2.57 13 11 25
MINI Plus Retest 18.46 ±3.62 18 15 29

20. Over all means of concordance of MINI
SCREEN To MINI Diagnoses
Questions of MINI SCREEN Kappa NPV PPV Efficienc
Versus MINI diagnoses y
All disorder’s questions 0.55 0.54 0.96 0.86
Drug dependence qs 0.78 0.89 0.93 0.94
Suicidal qs 0.68 0.71 0.95 0.88
Major depression qs 0.7 0.73 0.9 0.86
Antisocial personality qs 0.67 0.7 0.96 0.87
Anxiety disorders qs 0.49 0.41 0.99 0.89
Somatization dis qs 0.83 0.8 0.88 0.93

21. Hot items in MINI SCREEN of
alcohol & drug use disorders
DIAGNOSES Ranked hot items related
symptoms
1- Alcohol use disorders 1- drink & drive .
2- black out .
3- have memory loss while drinking.
4-become abusive when drinking .
5- drink to intoxication ,feel guilty
about drinking.
2- Drug use disorders 1-try to cut down ,try to control drug
use.
2- have a problem because of your
drug.
Need more of drug to get high and are
any one object to your drug use.

22. Hot items in MINI SCREEN of
Comorbid Psychiatric disorders in
alcohol & drug use disorders
DIAGNOSES Ranked hot items related
symptoms
1- Major depression 1- depression
2- Anxiety disorders 1- unexpected anxiety.
2- faintness.
3- sweaty palm.
4- unsteadiness.
5- diarrhea.
6- trembling.
3-Antisocial personality 1- intimidate others.
2- threaten other.
3- bully with other

24. DISCUSSION & CONCLUSION
1- MINI & precision of diagnosis in
psychiatry.
2- Sample study.
3- MINI, MINI PLUS: ( length of interview,
validity, and reliability).
4- MINI SCREEN .
5- Conclusion.

25. IMPLICATIONS
1- It is very beneficial to use MINI as a diagnostic
screening tool for psychiatric hospital
admission and out patient clinic evaluation.
2- MINI can be used as a first step in outcome
symptoms and disorders tracking, preparing for
establishing data base in substance use
disorders and management care service in
Arab world.
3. MINI Screen can be used in primary care
service.