Mini International Neuropsychiatric Interview Questionnaire Research Articles

Phenomenology of Depressive Disorders with and without Psychotic Features: A Comparative Study

ABSTRACT Background: Depressive disorders can present with psychotic features, which warrants a different diagnosis and a different phenomenological study. Aim: To study the phenomenology of depressive disorders with and without psychotic features. Methodology: One hundred and forty-eight patients presenting to psychiatry outpatient department of a tertiary care center were screened using Mini International Neuropsychiatric Interview questionnaire to select patients for our study. Sociodemographic data and some clinical variables of these patients were collected. These patients were further assessed for depression severity and psychotic symptoms by using Montgomery and Asberg Depression Rating Scale (MADRS) and Modified Psychotic Symptoms Ratings Scale (PSYRATS), respectively. Results: Mean MADRS score for patients with depression without psychotic features was 38.38 and for patients with depression with psychotic features was 44.51. Result was found to be significant. Suicidality was found to be on a higher side in patients of depression with psychotic features. Conclusion: Main finding related to our study was that depression severity was found to be more in patients of depression with psychotic features. There are certain phenomenological differences which warrant a separate diagnosis of depression with psychotic features. These include the increased intensity of suicidality, visible sadness, inner stress, difficulty in concentration, lassitude, altered ability to feel, and thoughts of suicide present in patients of depression with psychotic features.

Risk Factors for Psychiatric Disorders in Patients with Multiple Sclerosis-A Single-Center Study in the Polish Population.

Aim: The aim of this study was to determine the prevalence of mental disorders in a group of patients with multiple sclerosis (MS) during outpatient treatment. Additionally, an attempt was made to assess the influence of parameters related to patients and their clinical status on the prevalence of mental disorders. Materials and Methods: This study was conducted between 2017 and 2018 in a group of 103 patients with MS who underwent treatment at the Outpatient Clinic of Neurology at the Clinical Hospital No. 1 in Zabrze, Poland. Sociodemographic data were collected, and the course of the underlying disease and comorbidities underwent assessment. The Mini International Neuropsychiatric Interview (MINI) and psychiatric examination were used to assess the occurrence of mental disorders. Results: In this study, female subjects accounted for 67.96% of patients (mean age: 43 years). Of all patients, 67% of subjects were clinically diagnosed with mental disorders during their lifetime. The results of the MINI Questionnaire showed that 33% of MS patients had a history of a major depressive episode, while 8.7% of patients met the criteria for a depressive episode. The same number of patients were treated for recurrent depressive disorders. Generalized anxiety disorder was diagnosed in 10.7% of patients, agoraphobia in 8.7% and panic disorder in 7.8%. Most patients (94.2%) had a low risk of suicide, according to the MINI Questionnaire. This study did not show a significant influence of age, sex, duration of MS symptoms or severity of symptoms as expressed by the Expanded Disability Status Score (EDSS) on the prevalence of mental disorders (p = 0.05). However, a significantly higher median EDSS score was found in patients with a history of mental disorders (p = 0.03). Additionally, a significant negative correlation was found between having a family and a psychiatric diagnosis (p = 0.01). A statistically significant negative correlation was found between the level of education and the suicide risk as assessed by the MINI Questionnaire (p = 0.03). Conclusions: This study showed a high prevalence of mental disorders in patients with MS, of which depressive episodes and anxiety disorders were the most commonly reported. There may exist a relationship between the degree of disability of MS patients and a higher prevalence of mental disorders. Patients with MS who do not have a family may be more susceptible to mental disorders. In turn, patients with a lower level of education may show a higher risk of suicide. This suggests the need for psychological and psychiatric support for patients with MS, with particular consideration given to those who are alone, those with more severe disability and patients with a lower level of education.

Prevalence of psychiatric disorders among sentenced prisoners in a medium security prison in Ghana: Implications for mental healthassessment and service.

Extant literature has shown that there is a higher prevalence of mental disorders among prisoners compared to the general population. These findings have, however, mostly been from high-income and westernised cultures. In Ghana, little is known about the extent of psychiatric disorders among prisoners, as is consistent with the dearth of scholarly work in low and middle-income countries. Our aim was to determine the prevalence of common mental disorders among sentenced prisoners in the second largest prison in Ghana. A cross-sectional survey research design was used in one prison. The Mini International Neuro-Psychiatric Interview questionnaire was used to collect data from men and women serving prison sentences who volunteered for the study. Socio-demographic characteristics and criminal history data were collected using a questionnaire designed by the researchers. Five hundred prisoners participated. Nearly half (246, 49.8%) had at least one psychiatric disorder. The most prevalent disorders were major depression and a range of anxiety disorders (145, 29%, 132, 26% respectively). A smaller proportion recorded high scores on the antisocial personality disorder scale (13%); just 50 (10%) reported using substances in the 12months before interview, but this is a minimum estimate of such problems as many were already in prison during that time. None of these prisoners, regardless of disorder, had been screened, diagnosed, or treated in prison. This study contributes to the gap in scholarly literature in low- and middle-income countries on psychiatric disorders in the prison population. It will be important to explore further the extent to which the internationally recognised screening tools used led to under-estimation of psychiatric disorders. The findings are of immediate practical importance nationally as they highlight the need to implement reforms anticipated by the new mental health legislation of 2012 and strategies for interagency working to improve health services and their uptake in the criminal justice system.

Evaluation of stigma among patients reporting to a tertiary care psychiatric center

Background: Stigma toward mental illness is a pervasive concern that impacts the way psychiatric disorders are perceived. Aim: This study was aimed to evaluate the stigma experienced by patients visiting a psychiatric care facility and the associated factors contributing to the development of stigma. Methodology: 150 patients presenting to Psychiatry outpatient department of a tertiary care centre were screened using Mini international neuropsychiatric interview questionnaire to segregate patients into various psychiatric groups. These patients were further assessed for the degree of stigma utilizing the Stigma scale and Internalized Stigma of Mental Illness-10. Results: 60.7% of the participants reported facing discrimination, which was highest in those with mania. 67.3% patients preferred not to disclose their illness, especially those with psychotic disorders. Eighty-six percent did not expect any positive results from their illness, most of them with psychotic disorders. 68.7% of the patients experienced total stigma, highest in mania. Sixty-four percent experienced high internalized stigma mostly in mania. Stigma was irrespective of age, sex, education, employment, and family type. Conclusion: A large segment of participants in the study sample claimed to have suffered from stigma, i.e., they faced discrimination, preferred not to reveal information about their illness, denied any positive outcomes from their illness, and endured self-stigma owing to their illness. Patients with mania faced the most discrimination, total stigma, and internalized stigma whereas disclosure and positive aspects were mostly in psychotic disorders. High levels of stigma observed are a barrier to availing mental health-care facilities.

Depression among women with infertility versus pregnant women at General Hospital Ilorin: A comparative analytical study.

Objectives: Infertility is associated with emotional distress because of the pressure placed on the couples, especially women, in sub-Saharan Africa. The study found the prevalence of depression and associated factors among women attending infertility clinics and compared them with pregnant women at antenatal clinics.Methods: The study was a comparative analytical study consisting of 199 respondents with infertility and a control group of 200 pregnant women. General Health Questionnaire 12 was administered to both groups, and respondents that scored 3 points and above were administered the Mini International Neuropsychiatric Interview questionnaire (MINI) to make the diagnosis of depression and data were analysed.Results: The prevalence of depression among the case group was 52.0%, while the control was 9.5%. Factors associated with depression were longer duration of the marriage and women with utero-tubal infertility.Conclusion: Depression is common among women with infertility when compared with pregnant women.

Prevalence and factors associated with depression in people living with HIV/AIDS in a Brazilian metropolitan region

ABSTRACT The frequent association between mental disorders and HIV infection may be related to several risk factors. The present study aims to determine the prevalence of depression and its associated factors in people living with HIV/AIDS (PLWHA) who attended four outpatient clinics in Fortaleza, Brazil, between September 2014 and April 2015. In addition to the Mini International Neuropsychiatric Interview questionnaire, which was used to identify the prevalence of depressive disorder, the researchers applied a sociodemographic questionnaire, and the Hamilton Depression Scale to classify the severity of depression. In all, 257 participants were included in the analyses. The overall lifetime prevalence of depression was identified to be 29.2% (19.5% in men and 44.9% in women). The prevalence of a current depressive episode was 18.7%. Mild, moderate, and severe depression was identified in 2.1%, 12.5%, and 85.4%, respectively. The factors related to depression were: gender, marital status, income, educational level, current employment status, and family history of depression. This study highlights the importance of lifetime depression as a disorder of high prevalence in PLWHA, and associated with risk factors that are difficult or impossible to be modified. Early diagnosis and treatment of depression may improve quality of life in PLWHA.

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INTRODUCTION :Chronic obstructive pulmonary disease (COPD) is a progressive, partially reversible, preventable, and treatable lung disease which is characterized by long-term breathing problems which typically worsens over time. Acute exacerbations and frequent comorbidities contribute to the overall severity in individual patients and eventually everyday activities, such as walking or getting dressed, become difficult. Psychiatric illnesses are increasingly common in patients with chronic illnesses like COPD. Despite this, psychiatric co-morbidities among patients with COPD are less studied in comparison with general medical conditions.AIM :To study the psychiatric morbidity in individuals with COPD.METHODOLOGY :60 patients including inpatients and outpatients in the Department of Pulmonology, NRI Academy OF Medical Sciences, Guntur, diagnosed with COPD consenting for the study were included. Diagnosis of COPD was made using HRCT chest and pulmonary function tests(PFT).A descriptive study was done and psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview Questionnaire (MINI).RESULTS :Among the 60 patients two-third patients had psychiatric comorbidity.Anxiety and Depression were the most frequently diagnosed psychiatric disorders in the study and more than 50 % of the patients had history of smoking.There was a significant correlation between severity of COPD and psychiatric disorders.CONCLUSION :This study showed increased psychiatric morbidity in patients suffering from COPD. The presence of psychiatric disorders in COPD leads to increased morbidity. However, these have not been screened for routinely. Early detection and treatment of psychiatric comorbidity in COPD will help in reducing the morbidity and increase in the level of functioning.

Development and assessment of a community-based screening tool for mental health disorders among people who inject drugs.

The prevalence of mental health disorders among people who use drugs is high and well documented. This hard-to-reach population faces a very low awareness and access to mental health care, especially in developing countries. The objectives of this study were to design and assess a quick screening tool (QST) that community-based organisations (CBO) could routinely apply to a Vietnamese population of people who inject drugs (PWID), in order to refer them appropriately to mental health specialists. We devised a tool that included nine questions covering anxiety, depression, suicide risk and psychotic symptomatology. Its use required no specific background and 2 h training. Specificity and sensitivity of the QST were assessed in a population of 418 PWID recruited via respondent driven sampling, using the Mini International Neuropsychiatric Interview questionnaire plus clinical evaluation as a reference standard. Acceptability was assessed using a self-administered anonymous questionnaire submitted to all CBO members who used the QST. CBO members considered the QST easy to use, relevant and helpful to deal with mental health issues. Area under the curve for detection of any symptom using the QST was 0.770. The maximum sensitivity and specificity were reached with a cut-off of 2 [sensitivity was 71.1% (95% confidence interval 62.4, 78.8), specificity was 75.9% (70.5, 80.7)]. The QST appeared to be both efficient and well accepted. Given the burden of mental health problems among hard-to-reach PWID in developing countries, community-based screenings such as this one could be a particularly appropriate response.

Evaluation of suicide risk in medical students

OBJECTIVES: Suicide is considered a serious public health problem and especially affects medical students, who present a high prevalence of suicidal ideation, of approximately 11.1%. The aim of this study is to evaluate the risk of suicide in medical students from a University in an inland city of the State of São Paulo, Brazil.METHODS: This is a cross-sectional study carried out with 169 medical students from stages I, II, III and V of the medical course. Two questionnaires were employed: the module C of the Mini International Neuropsychiatric Interview (MINI), in which the risk of suicide was classified as “low” or “moderate/high”; and a survey with 23 questions about clinical and demographic factors potentially associated with suicide risk. A preliminary exploratory analysis was carried out to investigate this association and a subsequent logistic regression was employed to perform a multivariate analysis.RESULTS: of the students who responded to the MINI questionnaire, 131 (77.5%) showed a low risk of suicide and 37 (21.9%), a moderate/high risk. The variables that were associated with suicide risk were: family history of suicide (RR= 5.90; p=0.001) and the diagnosis of mental disorders (RR=3.96; p= 0.004). Alcohol consumption was associated with suicide risk in the preliminary bivariate analysis (RR=4; p=0.046), but this association did not remain significant in the final model of the multivariate analysis (RR=3.54; p=0.059).CONCLUSION: The results showed that a family history of suicide and the diagnosis of mental disorders were associated with suicide risk and can be used to identify students at risk, as well as to guide preventive strategies for its prevention in Medical Schools.

Longitudinal analysis of alcohol use and intimate partner violence perpetration among men with HIV in northern Vietnam

BackgroundAlcohol use is a known risk factor for male-perpetrated intimate partner violence (IPV), although few studies have been conducted globally and among men with HIV (MWH). We estimated the longitudinal effects of alcohol use on IPV perpetration among MWH. MethodsThis study is a secondary analysis of randomized controlled trial data among male and female antiretroviral treatment patients with hazardous alcohol use in Thai Nguyen, Vietnam. Analyses were restricted to male participants who were married/cohabitating (N = 313). Alcohol use was assessed as proportion days alcohol abstinent, heavy drinking, and alcohol use disorder (AUD) using the Timeline Followback and Mini International Neuropsychiatric Interview questionnaire. Multilevel modeling was used to estimate the effects of higher versus lower average alcohol use on IPV perpetration (between-person effects) and the effects of time-specific deviations in alcohol use on IPV perpetration (within-person effects). ResultsParticipants with higher average proportion days alcohol abstinent had decreased odds of IPV perpetration (adjusted Odds Ratio [aOR] = 0.43, p = 0.03) and those with higher average heavy drinking and AUD had increased odds of IPV perpetration (Heavy drinking: aOR = 1.05, p = 0.002; AUD: aOR = 4.74, p < 0.0001). Time-specific increases in proportion days alcohol abstinent were associated with decreased odds of IPV perpetration (aOR = 0.39, p = 0.02) and time-specific increases in AUD were associated with increased odds of IPV perpetration (aOR = 2.95, p = 0.001). Within-person effects for heavy drinking were non-significant. ConclusionsAlcohol use is associated with IPV perpetration among Vietnamese men with HIV. In this context, AUD and frequent drinking are stronger correlates of IPV perpetration as compared to heavy drinking.

Prediction of schizophrenia using MAOA-uVNTR polymorphism: A case-control study.

Context:Schizophrenia has been associated with disorder of the dopamine system, which is downregulated by projections of the serotonin pathway. Dopamine and serotonin levels are regulated by a system of transporters and enzymes. In this research, dopamine transporter polymorphism (DAT-VNTR), serotonin transporter polymorphism (5-HTTLPR), monoamine oxidase A (MAOA-uVNTR), and catechol-o-methyl transferase (COMT Val158Met) polymorphisms have been investigated.Aims:The aim of this study was to asses frequencies of these polymorphisms in the healthy control group and patients and to asses association with schizophrenia.Settings and Design:Three hundred and fourteen healthy volunteers and 306 schizophrenia patients were included. Schizophrenia was diagnosed by Diagnostic and Statistical Manual-IV of the American Psychiatric Association, and mini international neuropsychiatric interview questionnaire was used for screening of healthy population.Materials and Methods:Genotyping was performed using polymerase chain reaction (PCR) reaction followed by gel electrophoresis and PCR-restriction fragment length polymorphism.Statistical Analysis:Categorical data were analyzed using the Chi-square test, age between subgroups was compared using the Mann–Whitney test, and all polymorphisms were tested for Hardy–Weinberg equilibrium. Logistic regression analysis was used to set the prediction model of schizophrenia.Results:Difference in genotype distribution was observed for COMT Val158Met in female and DAT-VNTR polymorphism in overall sample P = 0.021 and P = 0.028, respectively. Statistically significant association of MAOA-uVNTR and schizophrenia was observed after adjustment for anamnestic predictors of disease. P = 0.010, 80.45% participants were correctly classified.Conclusion:Our results suggest an association of MAOA-uVNTR polymorphism with schizophrenia. The difference in the distribution of COMT Val158Met and DAT-VNTR polymorphism support the involvement of dopamine system components in the pathogenesis of schizophrenia.

Psychiatric Comorbidities among People Who Inject Drugs in Hai Phong, Vietnam: The Need for Screening and Innovative Interventions.

The objective of this study is to describe psychiatric comorbidities, associated factors, and access to psychiatric assessment and care in a cohort of people who inject drugs (PWID) in Hai Phong, Vietnam. Mental health was assessed after 12 months' follow-up using the Mini International Neuropsychiatric Interview questionnaire (MINI 5.0.0). PWID medical history, drug use, and sociodemographic and clinical characteristics were also collected. Among 188 PWID who participated in the assessment, 48 (25.5%) had at least one psychiatric disorder and 19 (10.1%) had 2 or more psychiatric disorders. The most common current psychiatric disorders were major depressive episode (12.2%) and psychotic disorder (4.8%), reaching 10.1% for the latter when lifetime prevalence was considered. Females were more likely than males to have at least one psychiatric disorder, a major depressive disorder, or an anxiety disorder. Methamphetamine use was associated with an increased risk of presenting a lifetime psychotic syndrome. Problematic alcohol consumption was associated with an increased risk of having at least one psychiatric disorder. Psychiatric comorbidities are frequent among PWID in Vietnam. These results highlight the need for routine assessment and innovative interventions to address mental health needs among PWID. Community-based interventions targeting mental health prevention and care should be strongly supported.

Prévalence des troubles mentaux en population générale au Burkina Faso

ObjectivesTo determine, with the use of the Mini-International Neuropsychiatric Interview (MINI), the prevalence of mental disorders in the general population of Burkina Faso; To identify the factors associated with the occurrence of these disorders. MethodsWe conducted a cross-sectional descriptive and analytical survey of a representative sample of the general population aged 18 years and over (n=2587). The only non-inclusion criterion was absence from the place of residence during the investigation period for whatever reason. This approach allowed us to select at random 840 households with a total number of 2587 persons aged 18 years and over. The data collection tools we used were a written questionnaire, developed by ourselves, and the Mini International Neuropsychiatric Interview or MINI questionnaire. On the ethical level, the protocol of this research and its appendices have received the prior approval of the Ethics Committee for Health Research of Burkina Faso as well as support from local customary and administrative authorities. ResultsThe surveyed population consisted of 1 479 women (57.17 %) and 1108 men (42.83 %). Of the 2 587 people surveyed, 1 072 or 41.43 % met the criteria for at least one of the mental disorders. The prevalence rate was significantly higher among women than men (46.24 % versus 35.01 %). The depressive episode was the most frequent disorder in the surveyed population (11.60 %). Gender, place of residence and marital status were the main factors significantly associated with the occurrence of mental disorders. ConclusionThis first national survey revealed a high prevalence of mental disorders. Considering the importance of mental disorders in the general population, it is important to train and involve more nurses and general practitioners in the identification and management of these disorders as there are very few specialists in the field at present.

Pilot of a randomised controlled trial of the selective serotonin reuptake inhibitor sertraline versus cognitive behavioural therapy for anxiety symptoms in people with generalised anxiety disorder who have failed to respond to low-intensity psychological treatments as defined by the National Institute for Health and Care Excellence guidelines.

Generalised anxiety disorder (GAD) is common, causing unpleasant symptoms and impaired functioning. The National Institute for Health and Care Excellence (NICE) guidelines have established good evidence for low-intensity psychological interventions, but a significant number of patients will not respond and require more intensive step 3 interventions, recommended as either high-intensity cognitive behavioural therapy (CBT) or a pharmacological treatment such as sertraline. However, there are no head-to-head comparisons evaluating which is more clinically effective and cost-effective, and current guidelines suggest that treatment choice at step 3 is based mainly on patient preference. To assess clinical effectiveness and cost-effectiveness at 12 months of treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline compared with CBT for patients with persistent GAD not improved with NICE-defined low-intensity psychological interventions. Participant randomised trial comparing treatment with sertraline with high-intensity CBT for patients with GAD who had not responded to low-intensity psychological interventions. Community-based recruitment from local Improving Access to Psychological Therapies (IAPT) services. Four pilot services located in urban, suburban and semirural settings. People considered likely to have GAD and not responding to low-intensity psychological interventions identified at review by IAPT psychological well-being practitioners (PWPs). Those scoring ≥ 10 on the Generalised Anxiety Disorder-7 (GAD-7) anxiety measure were asked to consider involvement in the trial. Aged ≥ 18 years, a score of ≥ 10 on the GAD-7, a primary diagnosis of GAD diagnosed on the Mini International Neuropsychiatric Interview questionnaire and failure to respond to NICE-defined low-intensity interventions. Inability to participate because of insufficient English or cognitive impairment, current major depression, comorbid anxiety disorder(s) causing greater distress than GAD, significant dependence on alcohol or illicit drugs, comorbid psychotic disorder, received antidepressants in past 8 weeks or high-intensity psychological therapy in previous 6 months and any contraindications to treatment with sertraline. Consenting eligible participants randomised via an independent, web-based, computerised system. (1) The SSRI sertraline prescribed in therapeutic doses by the patient's general practitioner for 12 months and (2) 14 (± 2) CBT sessions delivered by high-intensity IAPT psychological therapists in accordance with a standardised manual designed for GAD. The primary outcome was the Hospital Anxiety and Depression Scale - Anxiety component at 12 months. Secondary outcomes included measures of depression, social functioning, comorbid anxiety disorders, patient satisfaction and economic evaluation, collected by postal self-completion questionnaires. Only seven internal pilot participants were recruited against a target of 40 participants at 7 months. Far fewer potential participants were identified than anticipated from IAPT services, probably because PWPs rarely considered GAD the main treatment priority. Of those identified, three-quarters declined participation; the majority (30/45) were reluctant to consider the possibility of randomisation to medication. Poor recruitment was the main limiting factor, and the trial closed prematurely. It is unclear how much of the recruitment difficulty was a result of conducting the trial within a psychological therapy service and how much was possibly a result of difficulty identifying participants with primary GAD. It may be easier to answer this important question by recruiting people from primary care rather than from those already engaged in a psychological treatment service. Current Controlled Trials ISCRTN14845583. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 45. See the NIHR Journals Library website for further project information.

Validation of the MINI (DSM IV) Tool for the Assessment of Alcohol Dependence among Young People in Northern Tanzania Using the Alcohol Biomarker Phosphatidylethanol (PEth).

The alcohol dependence section of the Mini International Neuropsychiatric Interview questionnaire (MINI) has not been evaluated in young Africans. We applied the MINI in a cross-sectional study of 202 alcohol users from northern-Tanzania, aged 18–24 years (103 male casual workers and 99 students), and validated it against phophatidylethanol (PEth) at a cut-off suggesting heavy chronic alcohol use (≥0.30 µmol/L). Blood was assayed for PEth (16:0/18:1-subform) by liquid chromatography-tandem mass spectrometry. The MINI dependence criteria (≥3 positive responses) were met by 39% participants although their PEth levels were low. Contrary, many young people with high PEth levels were not classified as dependent. The sensitivity of the MINI ranged from 0% to 69% (female students and male workers, respectively) and specificity from 52% to 85% (workers and female students, respectively). The highest AUROC (0.68) occurred with a cut-off of ≥4 positive responses. A modified MINI with three affirmative responses to five questions increased specificity to 92%–97%; however, sensitivity remained low. The performance of the MINI in detecting dependence among young people from northern-Tanzania is unsatisfactory. Specificity was improved using a modified version but sensitivity remained low. An accurate tool for the diagnosis of alcohol dependence is needed for epidemiological and clinical purposes.

Depression in dermatological patients identified by the Mini International Neuropsychiatric Interview questionnaire

Early diagnosis and treatment of depression are of vital importance in dermatological patients. Our purpose was to evaluate the prevalence of depression among patients visiting a dermatology clinic in southern Israel. Patients who visited the dermatology clinic were interviewed using the Mini International Neuropsychiatric Interview screening tool. The study included 384 patients. The screening questionnaire identified 37 patients (9.6%) with major depression, 3 patients (0.8%) with minor depression, and 74 patients (19.3%) with depressive symptoms. Higher prevalence of depression was found among widowers, among divorced or separated patients, and in unemployed patients. Depression was significantly associated with the perception of severity and suffering induced by the skin diseases. The study was conducted in a cross-sectional design. To confirm causality, a longitudinal study should be conducted. Depression should be a consideration by dermatologists in the effective management of skin diseases.

Health services utilization by depressive patients identified by the MINI questionnaire in a primary care setting

ObjectivesTo identify patients with depression, in primary care clinics in Israel, using the MINI (Mini-International Neuropsychiatric Interview) as a screening tool and to evaluate the health services utilization and costs of the patients identified. DesignPhone interviews (between 1997 and 2000) and health services utilization data extracted from computerized databases. SettingThree primary care clinics belonging to Clalit Health Services (HMO). ParticipantsA random sample of 2755 patients, aged 21–65. Main outcome measuresMINI score results, utilization data. ResultsThe study included interviews with 2507 patients. The screening questionnaire identified 5.9% with major depression, 1.6% with minor depression and 14.3% with depressive symptoms. Higher rates of depression were found among women, immigrants, secular or traditional religious Jews, and the unemployed. Those identified with major depression had higher health services utilization and costs. Logistic regression analysis showed that depression was related to older age, female gender, fewer years of education and among seculars. Depressed patients had significantly more somatic comorbidity. ConclusionsHealth services utilization and costs of people identified as depressed by the screening tool were higher. Depressive patients had higher comorbidity, which might be partially responsible for the higher cost.