Evaluation of Reliability and Validity of MINI-Screening of Mental Disorders (MINI-SMD)

Author(s)

Lívia Maria Bolsoni

• Document type: Master's Dissertation
• Press: Ribeirão Preto.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina de Ribeirão Preto (PCARP/BC)
• Defense date: 2016-04-28

Examining board members

Antonio Waldo Zuardi; Cristina Marta Del Ben; Clarice Gorenstein

• Advisor: Antonio Waldo Zuardi

Abstract

Current studies raise awareness of primary care on management of mental disorder issues and the use of screening tools allows the measurement of physical, psychological and behavioral features not always considered. Therefore, the use of screening tools may aid early detection of individuals who require treatment, assistance or intervention. In addition, screening tools that allow that allow the identification of multiple mental disorders are uncommon. Therefore, the current study aimed to build and validate a brief tool that tracks multiple mental disorders to be named Mini Screening for Mental Disorders (in Portuguese, MINI-RTM) that gathers relevant issues from various mental disorder screening tools already validated, with the addition of allowing the identification of commonplace disorders such as substance abuse and psychotic disorder. MINI-SMD comprehends questions related to anxiety, alcohol or substance abuse and/or addiction, as well as psychotic disorders. The instrument comprises nine items in which scores vary from zero to 23. 545 participants were interviewed at their homes by medicine students with training at MINI-RTM and Feelings from COOP/WONKA. The subjects who agreed to participate in the second phase of the study, total 230, received a second visit from mental health professionals with training in MINI-SMD, the item Feelings of COOP/WONCA and the MINI interview for possible confirmation of diagnosis. The MINI-SMD was subject to test-retest reliability analysis, through intraclass correlation coefficient (ICC), with value 0.78, considered satisfactory, indicating to be a very reliable instrument with more expressive indexes than Feelings from COOP / WONCA. The analysis of discriminant validity showed that MINI-RTM presented satisfactory values under the ROC curve, sensitivity, specificity, positive predictive value and negative predictive value. Cut scores when compared with the gold standard MINI interview were: > 3 (more sensitive instrument) and> 4 (more specific instrument). When collated with Feelings for better accuracy scores, MINI-RTM presented less variation between sensitivity and specificity, being considered more balanced in detecting cases and non-cases. With respect to the analysis of concurrent validity, compared to Feelings, MINI-RTM presented moderate correlation value, which has been expected since Feelings assesses well-being and not a set of disorders. Thus, MINI-RTM was presented as a potentially important screening tool for tracking multiple mental disorders in primary health care, being satisfactorily reliable, valid and more comprehensive than other screening tools. MINI-RTM managed to gather important features for a screening instrument such as high capacity of discrimination between cases and noncases and easy applicability. This tool is available for primary health care professionals, filling an important gap in the literature - mainly Brazilian - which is the provision of a tool that tracks multiple mental disorders, not only limited to the assessment of well-being or the general assessment of specific mental disorders (AU)

• FAPESP's process: 13/20967-3 - Evaluation of reliability and validity of the MINI: compendium for Tracking Mental Disorders (MINI-RTM)
• Grantee: Lívia Maria Bolsoni
• Support Opportunities: Scholarships in Brazil - Master