Validity and Applicability of the Mini International Neuropsychiatric Interview Administered by Family Resident Physicians in Primary Health Care in Brazil

Abstract

Purpose:

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

Methods:

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.

Results:

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.

Conclusions:

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.