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首页> 外文期刊>International Journal of Bipolar Disorders >Evaluating depressive symptoms in hypomanic and manic episodes using a structured diagnostic tool: validation of a new Mini International Neuropsychiatric Interview (M.I.N.I.) module for the DSM-5 'With Mixed Features’ specifier
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Evaluating depressive symptoms in hypomanic and manic episodes using a structured diagnostic tool: validation of a new Mini International Neuropsychiatric Interview (M.I.N.I.) module for the DSM-5 'With Mixed Features’ specifier

机译：使用结构化诊断工具评估躁狂和躁狂发作中的抑郁症状：验证适用于DSM-5“具有混合功能”说明符的新的Mini International Neuropsychiatric Interview（M.I.N.I.）模块

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Background The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), includes a new 'With Mixed Features’ specifier for mood episodes. In (hypo-)manic episodes, the specifier is given if three or more depressive symptoms are present nearly every day during the episode. A new module of the Mini International Neuropsychiatric Interview (M.I.N.I.) has been developed as a patient-completed questionnaire to evaluate the DSM-5 specifier for (hypo-)manic episodes. The objective of this study was to validate this new module. Methods In Phase I, patients with a manic episode in the past 6 months completed the module and were asked whether the wording was clear, understandable, relevant and specific. Based on their feedback, the module was refined and finalised. In Phase II, psychiatrists each invited five patients to complete the module. The psychiatrists completed record forms for these five patients, which included their diagnoses, made according to DSM-5 criteria during clinical interviewing. The module was validated by comparing depressive symptoms reported by the patients themselves using the M.I.N.I. module with those evaluated by their psychiatrist using DSM-5 criteria during clinical interviewing. Results and discussion In Phase I, a few changes were made to the M.I.N.I. module based on feedback from 20 patients (60% of whom had mixed features). In Phase II, 23 psychiatrists completed record forms for 115 patients, 99 (86.1%) of whom completed the M.I.N.I. module. Agreement between psychiatrists' DSM-5 diagnoses and patients' M.I.N.I. responses was substantial (Cohen's kappa coefficient, 0.60). The overall sensitivity of the M.I.N.I. was 0.91 and its specificity was 0.70. Sensitivity ranged from 0.63 for psychomotor retardation to 0.90 for suicidal thoughts. Specificity ranged from 0.63 for diminished interest/pleasure to 0.90 for suicidal thoughts. The module's positive and negative predictive values were 0.72 and 0.90, respectively. In summary, the M.I.N.I. module demonstrated good concurrent validity with psychiatrists' evaluation of DSM-5 mixed features in manic patients, accurately detecting mixed features with limited risk of over-diagnosis. Due to its simplicity, the M.I.N.I. module could be incorporated into routine psychiatric evaluation of patients with manic episodes. It could also provide a valuable standardised tool for clinical and epidemiological research. Electronic supplementary material The online version of this article (doi:10.1186/2194-7511-1-21) contains supplementary material, which is available to authorized users.
机译：背景技术《精神疾病诊断和统计手册》第五版（DSM-5）包括针对情绪发作的新的“具有混合特征”说明符。在（低躁狂）发作中，如果发作期间几乎每天都出现三种或更多种抑郁症状，则给出说明符。迷你国际神经精神病学访谈（M.I.N.I.）的新模块已作为患者填写的问卷进行了开发，以评估DSM-5指定者的躁狂发作。这项研究的目的是验证此新模块。方法在第一阶段，在过去6个月中出现躁狂发作的患者完成了该模块，并询问其措词是否清晰，可理解，相关且特定。根据他们的反馈，对模块进行了完善和最终确定。在第二阶段，精神科医生分别邀请了五名患者来完成该模块。精神科医生完成了这五名患者的记录表，其中包括他们的诊断，这些记录是根据临床访谈期间根据DSM-5标准制定的。该模块通过比较患者自己使用M.I.N.I.与他们的精神病医生在临床访谈期间使用DSM-5标准评估的模块进行比较。结果与讨论在第一阶段，对M.I.N.I.进行了一些更改。该模块基于20位患者（其中60％具有混合特征）的反馈。在第二阶段，有23位精神科医生完成了115位患者的记录表格，其中99位（86.1％）完成了M.I.N.I.模块。精神科医生的DSM-5诊断与患者的M.I.N.I.回应是实质性的（科恩卡帕系数为0.60）。 M.I.N.I.的整体敏感性为0.91，特异性为0.70。敏感性的范围从对精神运动迟缓的0.63到对自杀念头的0.90。特异性的范围从对兴趣/愉悦感降低的0.63到对自杀念头的0.90。该模块的正预测值和负预测值分别为0.72和0.90。总之，M.I.N.I。该模块与精神科医生对躁狂患者中DSM-5混合特征的评估显示出良好的并发有效性，可准确检测出混合特征，而过度诊断的风险有限。由于其简单性，M.I.N.I。该模块可以纳入躁狂发作患者的常规精神病学评估中。它还可以为临床和流行病学研究提供有价值的标准化工具。电子补充材料本文的在线版本（doi：10.1186 / 2194-7511-1-21）包含补充材料，授权用户可以使用。

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