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

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

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    Copy (2) of validity and reliability of      mini – arabic in Copy (2) of validity and reliability of mini – arabic in Presentation Transcript

    • 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
    • The Study Need & Hypothesis
    • Aim of The Work
    • Aim of The Work Primary:1- to examine the concordancebetween the MINI-Arabic and theCIDI –Arabic, and between theSubstance use modules in bothMINI PLUS-Arabic & CIDI –Arabic .
    • 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.
    • 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.
    • SUBJECTS And METHOD
    • Subjects:1- Patient Group: A- Inclusion criteria. B- Exclusion criteria. C- Selection of cases.2- Control Group.
    • Method: 1- Procedure. 2- Tools applied in this work . 3- Statistical analysis.
    • 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
    • Tools Applied in This Work1- 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).
    • 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 ) .
    • RESULTSRESULT
    • Demographic DataVariable PATIENTS DEPENDENCE AND ABUSE Control X2 Chi- Sig (P) square FREQ. % FREQ. %Age 4.8 >0.0514-20 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 >0.05Male 113 95.8% 54 90%Female 5 4.2% 6 10%Religion 0.399 >0.05Moslem 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 0Widow 1 0.8% 0 0Occupation 4 8.196 >0.05Professional 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 >0.05Illiterate 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%
    • Validity of MINICONCORDANC - + Kappa Sensitivity specificity NPV ppv EfficiencyE RATINGS TN FN FP TPCURRENT 155 3 0.83 0.83 O.97 O.97 0.83 O.96ALC.DEP. IN 3 17MINI & CIDIDSM-III N= 178CURRENT 153 3 0.73 0.82 O.97 O.98 O.75 O.94ALC.DEP. INMINI & CIDIICD-10 5 17LIFE TIME ALC. 93 8 O.55 O.86 O.73 O.93 O.57 O.77DEP. IN MINI &CIDI DSM-III 30 47LIFE TIME ALC. 89 8 O.5 O.87 O.71 O.92 O.57 O.76DEP. IN MINI &CIDI-ICD10 34 47CURRENT 71 3 O.73 O.96 O.83 O.95 O.86 O.73DRUG DEP. INMINI & CIDI 14 90DSM-III
    • Validity of MINI ( CONT.)CONCORDANC - + Kappa Sensitivity specificity NPV ppv EfficiencyE RATINGS TN FN FP TPLIFE TIME 55 11 0.71 0.9 0.79 0.83 0.83 0.86DRUGDEPENDENCE 15 97IN MINI & CIDIICD-10CURRENT 167 0 0.9 1 0.98 0.94 0.83 0.99DRUG ABUSEIN MINI & CIDI 2 9DSMIIICURRENT 164 0 0.62 1 0.97 1 0.63 0.95DRUG ABUSEIN MINI AND 5 9CIDI ICD-10LIFE TIME 163 0 0.86 1 0.98 1 0.75 0.98DRUG ABUSEIN MINI & CIDI 4 11DSMIILIFE TIME 159 0 0.76 1 0.96 1 0.64 0.96DRUG ABUSEIN MINI AND 8 11CIDI ICD-10
    • Validity of MINI ( CONT.)CONCORDANC - + Kappa Sensitivity specificity NPV ppv EfficiencyE RATINGS TN FN FP TPCOMORBID 99 1 0.84 0.97 O.88 O.98 0.84 O.92DIAG IN MINI &CIDI DSMIII 12 65COMORBID 101 1 0.82 0.97 O.88 O.98 O.81 O.91DIAG IN MINI &CIDI ICD 10 14 62ALC & DRUG 56 5 O.87 O.95 O.91 O.91 O.95 O.94USE IN MINI &CLINICAL 5 112IMPRESSIONCOMORBID 99 4 O.77 O.94 O.9 O.97 O.79 O.89DIAG IN MINI &CLINICAL 16 59IMPRESSION
    • RELIABILTY OF MINI Diagnoses ( n=118) Inter- rater Retest (Kappa) (Kappa)MINI 0.89 0.93MINI PLUS ( ALCOHOL & 0.91 0.98DRUG CURRENT)MINI PLUS ( ALCOHOL & 0.94 0.89DRUG LIFE TIME )MINI PLUS ( COMORBID 0.85 0.84PSYCHIATRICDISORDERS)
    • 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 65MINI 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
    • Over all means of concordance of MINI SCREEN To MINI DiagnosesQuestions of MINI SCREEN Kappa NPV PPV EfficiencVersus 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
    • Hot items in MINI SCREEN of alcohol & drug use disordersDIAGNOSES Ranked hot items related symptoms1- 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.
    • Hot items in MINI SCREEN of Comorbid Psychiatric disorders in alcohol & drug use disordersDIAGNOSES Ranked hot items related symptoms1- Major depression 1- depression2- 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
    • DISCUSSION & CONCLUSION1- MINI & precision of diagnosis in psychiatry.2- Sample study.3- MINI, MINI PLUS: ( length of interview, validity, and reliability).4- MINI SCREEN .5- Conclusion.
    • IMPLICATIONS1- 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.