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The M.I.N.I. was developed by Sheehan et al. [14] to explore some psychiatric disorders according to the DSM and ICD diagnostic criteria. Every few years, the M.I.N.I. is updated and validated versions in other languages also become available [14]. Initially, the M.I.N.I. was designed to meet the need for a short yet valid and reliable psychiatric interview for multicenter clinical trials and epidemiological studies. However, in recent years, the assessment tool is also being used in humanitarian aid and global health settings [7]. The M.I.N.I. is particularly attractive since it offers a fee waiver for researchers and clinicians who will use the assessment to assist refugees or victims of terrorism (for more information see -international-neuropsychiatric-interview-mini/). This stipulation may be more relevant now than ever, as refugee groups resettle worldwide.
A sample of 102 participants was recruited between April 2019 to March 2020. Inclusion criteria were defined as age between 18 and 75 years and native Arabic speakers. Initially, two interviewers received in-depth structured training and supervision by two licensed psychologists to ensure consistency in the administration of the interview process. In the next step, participants received an information sheet about the study aims and were asked for their interest in participation. Throughout the whole study process, participants were encouraged to ask any questions that remain unclear. Participants who were interested and willing to participate gave their signed informed consent before any trial-related procedures were conducted. Study participation was voluntary, and no monetary compensation was provided. In the next step, participant symptomatology was assessed by using rater-based and self-rated measures, including the Mini International Neuropsychiatric Interview (M.I.N.I.), the Patient Health Questionnaire (PHQ-9), and the Harvard Trauma Questionnaire (HTQ). All assessments were conducted in Arabic. In parallel, participants were also seen by an Arabic-speaking licensed psychiatrist for a diagnostic assessment and consultation. Three separate psychiatrists were available in rotation at the outpatient clinic. Both interviewers and the psychiatrist were blind to the diagnosis of each other. The whole assessment procedure took between 60 and 90 min. The study was approved by the ethics committee of Charité - Universitätsmedizin Berlin, Germany, and is in line with the Declaration of Helsinki.
Recent studies have highlighted that patients from a Muslim cultural background may experience feelings of discomfort when alone with a therapist from the opposite gender [38], sometimes resulting in an inaccurate representation of symptoms during psychiatric evaluation. In the present study, gender may have played a role in participant responses. Matching gender between psychiatrists and patients was not always possible in the expert interviews, whereas there was more flexibility in the administration of the M.I.N.I.. Since the M.I.N.I. was designed to be administered by non-specialists, it provides an efficient solution to the shortage of available specialized professional care, who sometimes lack the language skills and cultural competence training needed in diagnosing Arabic-speaking populations. Taken together, these reports may explain the slight to moderate Kappa values when comparing the M.I.N.I.-AR and expert diagnoses. Nonetheless, the specific effect of matching gender was not within the scope of this paper, however, it may be interesting to assess this in future validation studies.
The MINI-Plus 5.0.0 is an internationally validated brief structured interview that is used extensively as a diagnostic tool for psychiatric disorders from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the International Classification of Diseases-10. The reliability and validity of this instrument is well established [24], and the Korean translation is also validated [19].
The GAD-7 and GAD-2 were designed for use in primary care patients [15, 16]. The GAD-7 consists of a self-report questionnaire that allows for the rapid detection of GAD [15]. Subjects are asked if they were bothered by anxiety related problems over the past two weeks by answering seven items on a 4-point scale. The total scores ranged from 0 to 21. At a cutoff score of 9, the GAD-7 had a sensitivity of 89 % and a specificity of 82 % for detecting GAD compared with a structured psychiatric interview [15]. The GAD-2 is a short version of the tool that is composed of the first two questions of the GAD-7 [16]. At a cutoff score of 2, the GAD-2 had a sensitivity of 86 % and a specificity of 83 % for detecting GAD [16]. The GAD-7 was translated into the Korean language, and was freely downloadable on the Patient Health Questionnaire website (www.phqscreeners.com) [25]. The translated version was translated back into English by a Korean English teacher. Finally, the two versions were compared by a native English speaker who concluded that they were identical. Thereafter, we administered it to 20 Korean PWE for the evaluation of potential problems in comprehension or cultural differences. No further adaptations were required.
The Mini-International Neuropsychiatric Interview (M.I.N.I.) is a short structured diagnostic interview, developed jointly by psychiatrists and clinicians in the United States and Europe, for DSM-IV and ICD-10 psychiatric disorders. With an administration time of approximately 15 minutes, it was designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies and to be used as a first step in outcome tracking in nonresearch clinical settings. The authors describe the development of the M.I.N.I. and its family of interviews: the M.I.N.I.-Screen, the M.I.N.I.-Plus, and the M.I.N.I.-Kid. They report on validation of the M.I.N.I. in relation to the Structured Clinical Interview for DSM-III-R, Patient Version, the Composite International Diagnostic Interview, and expert professional opinion, and they comment on potential applications for this interview.
Short and ultra-short prototypes were developed for Major Depressive Disorder (MDD), Generalised Anxiety Disorder (GAD), Panic Disorder (PD) and Social Phobia (SP). Prototypes were compared to typical short and ultra-short self-report screening scales, such as the Centre for Epidemiology Scale, CES-D and the GAD-7, and their short forms. The Mini International Neuropsychiatric Interview (MINI) version 6 [1] was used as the gold standard for obtaining clinical criteria through a telephone interview. From a population sample, 225 individuals who endorsed a prototype and 101 who did not were administered the MINI. Receiver operating characteristic (ROC) curves were plotted for the short and ultra short prototypes and for the short and ultra short screening scales.
The Mini International Neuropsychiatric Interview (MINI) version 6 [1] was used as the gold standard for obtaining clinical criteria for comparing the sensitivity and specificity of the prototypes to the scales. The MINI is a brief interview that has strong concordance with diagnoses based on the Structured Clinical Interview for DSM-III-R (SCID) or the Composite International Diagnostic Interview (CIDI) [30]. Only the modules assessing depression, social phobia, panic disorder and generalised anxiety disorder (GAD) were administered, corresponding to each of the prototypes being assessed. Exclusion criteria including drug use, medication use and alternative diagnosis (for GAD) were not assessed, to maintain comparability to the prototypes and scales used in the survey.
Surveys included the short and the ultra short versions of the prototypes, the four standard scales and their short forms (CES-D, GAD-7, SPIN and PDSS-SR), questions on background characteristics, and a consent form for clinical interview. These surveys were mailed to the 14,000 potential participants, along with information about the study. A subsample of respondents was then selected for a clinical interview. An algorithm for clinical interview selection was designed prior to the study, aiming to administer clinical interviews with all of the respondents with high scores on the prototypes and some of the participants with low scores according to a weekly quota system. A random sample of respondents who did not identify with any of the prototypes was also selected for interview. Only participants who provided a telephone number and consented to be interviewed were contacted. Participants who identified at any level with the schizophrenia prototype (n = 64) were excluded from having a phone interview.
The clinical interviews (MINI) were conducted over the telephone by a team of four clinical psychology postgraduate students and one trainee clinical psychologist, all of whom received three hours of training in the administration of the clinical interview, including a videoconference with the authors of the MINI. From the 2,976 respondents, 1,257 consented and were eligible for a clinical interview. A total of 349 participants who endorsed a prototype and 129 who did not endorse a prototype were selected for clinical interviews. Of those selected, interviews were completed with 225 endorsers (64.5%) and 101 non-endorsers (78.3%). Up to seven call attempts were made in order to contact each of the selected participants, with a two-week window given to make contact after the survey was returned. Clinical interviewers were blinded to the survey responses of the interviewees. The sampling procedure is shown in Figure 1.
We used a validated Norwegian translation of the Life Events Checklist (LEC) to assess exposure to potentially traumatic events (Halvorsen and Stenmark 2010). The LEC is a 17-item self-report questionnaire, but we administered it as part of the structured interview. The LEC has good temporal stability and reliability (Gray et al. 2004). 2b1af7f3a8