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.

Abstract

ObjectiveTo 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.DesignData were collected from a prospective observational study, ADAS, between 2014 and 2015.SettingTwenty-eight primary care centers in Region Västra Gotaland, Sweden.PatientsA 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 MeasuresScores 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.ResultsUsing 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%.ConclusionWith 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.