Correspondence Between the Neuropsychiatric Interview M.I.N.I. and the BDI-II and MADRS-S Self-Rating Instruments as Diagnostic Tools in Primary Care Patients with Depression
Received 20 December 2019
Accepted for publication 27 March 2020
Published 14 May 2020 Volume 2020:13 Pages 177—183
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Shabnam Nejati,1 Nashmil Ariai,1 Cecilia Björkelund,1 Ingmarie Skoglund,1,2 Eva-Lisa Petersson,1,2 Pia Augustsson,2 Dominique Hange,1,2 Irene Svenningsson1,2
1Primary Health Care/School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; 2Narhalsan Research and Development Primary Health Care, Region Vastra Gotaland, Gothenburg, Sweden
Correspondence: Dominique Hange
Primary Health Care/School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 454, Gothenburg SE-405 30, Sweden
Tel +46 722 245 700
Objective: To investigate the correspondence between the diagnoses received by patients with symptoms of common mental disorder attending primary care, based on the diagnostic instrument International Neuropsychiatric Interview (M.I.N.I.) and the self-assessment instruments such as Beck Depression Inventory (BDI-II) and Montgomery–Asberg Depression Rating Scale – self-rating version (MADRS-S), respectively.
Design: Data were collected from a prospective observational study, ADAS, between 2014 and 2015.
Setting: Twenty-eight primary care centers in Region Västra Gotaland, Sweden.
Patients: A total of 192 patients, 18– 60 years of age, on sick leave ≥ 14 days, with mild/moderate depression, anxiety syndrome, and stress-related mental illness were included.
Main Outcome Measures: Scores of the assessment instruments (BDI-II and MADRS-S) on inclusion, sensitivity, specificity, positive (PPV) and negative predictive value (NPV) for BDI-II and MADRS-S, respectively, with M.I.N.I used as diagnostic instrument.
Results: Using M.I.N.I. as gold standard, the BDI-II and MADRS-S showed almost the same sensitivity (86.9% and 87.4%, respectively), but specificity for MADRS-S was doubled compared to BDI-II (36% and 18%, respectively). There was a significant association between MADRS-S and M.I.N.I. (p=0.027). However, the same analysis between BDI and M.I.N.I. was not statistically significant (p= 0.635). NPV and PPV were calculated from assumed prevalences (10% and 75%) and were higher for MADRS-S compared to BDI-II. The PPV differences were between 2% and 7% and NPV differences were between 3% and 19%.
Conclusion: With M.I.N.I. as gold standard, MADRS-S performs better than BDI-II as a self-assessment tool in the primary care context for depression diagnostics.
Keywords: depression, diagnostic instrument, primary care, self-assessment instrument
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