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Table of Contents
Mini International Neuropsychiatric Interview
The Mini International Neuropsychiatric Interview (MINI) (section: mental health) was measured in all adult Lifelines participants during:
- 1A Visit 1 (as interview, n = ~149.000, only with MMSE score of 26 or more)
- 2A Visit 1 (as a digital questionnaire on location, n = ~119.000)
- 3A Visit 1 (as a digital questionnaire at home)
Background
The Mini International Neuropsychiatric Interview (MINI) is a brief, reliable and valid structured diagnostic interview for diagnosing psychiatric disorders, compatible with international diagnostic criteria such as the DSM-IV and ICD-10.
The MINI was performed in adult and elderly Lifelines participants as a face-to-face interview with a nurse practitioner on location during 1A Visit 1, and as a digital questionnaire on location during 2A Visit 1. In general assessment 3A, the MINI is implemented as a digital questionnaire to be filled in at home.
The MINI should not be confused with the Mini Mental State Examination which is also used in Lifelines, but measures cognitive impairments.
In addition to the MINI, which asks questions on altered mood during various time intervals, the additional assessment BIOQ was performed to assess lifetime mood-related episodes (LIDAS).
The MINI used in the Lifelines cohort (section: mental health) is restricted to the following therapeutic indications:
- major depressive episode
- dysthymia
- panic disorder
- agoraphobia
- social phobia
- generalized anxiety disorder
Versions of the MINI
In 1A Visit 1, three different versions of the MINI (face-to-face interview) were used.
- MINI v1 (pilot): from 08-11-2006 until 14-12-2007 (answers entered by medical professional)
- MINI v2: from 17-12-2007 until 16-02-2012 (answers entered by medical professional)
- MINI v3: from 17-02-2011 until 31-12-2013 (answers entered by medical professional)
In 2A Visit 1 (and in ADHQ), the digital self-report MINI (D/v4) was used.
MINI v1 differs from MINI v2-3-4 as follows:
- some questions differ in the reference period on which the complaint/syndrome should be reported;
- some questions are differently phrased;
- some questions differ in content;
- it contains fewer questions than the later versions
MINI v2 and v3 contain the same questions, but MINI v2 contains skips when certain questions are answered “no” (as instructed in the manual of the MINI version 5.0.0), whereas some of these skips were removed in MINI v3 and v4 in order to get a more complete and detailed overview of mood changes in Lifelines participants.
MINI D/v4 is essentially the same as v3, except that some original questions were divided into multiple variables (explaining the higher numbers in Table 4), and this version was performed as a digital questionnaire rather than a face-to-face interview.
Table 4 gives an overview of the number of items per diagnosis for every Lifelines version of the MINI.
| Disorder | Variable | MINI v1 | MINI v2 | MINI v3 | MINI v4 |
|---|---|---|---|---|---|
| Major depressive disorder | A | 10 | 11 | 11 | 16 |
| Dysthymia | B | 9 | 9 | 9 | 9 |
| Panic disorder | E | 4 | 17 | 17 | 18 |
| Agoraphobia | F | 2 | 2 | 2 | 2 |
| Social phobia | G | 4 | 4 | 4 | 4 |
| Generalized anxiety disorder | H | 9 | 9 | 9 | 10 |
| Total | 38 | 52 | 52 | 59 |
Covid-19
In April 2020, an additional assessment was started to measure the effects of the 2020 Corona crisis on (amongst others) the mental health and wellbeing of Lifelines participants. The following questions were adapted from the MINI and used in the assessment:
| Questions English | Questions Dutch | Variable | Assessment | Age |
| In the last 7/14 days have you felt low or depressed for much of the day, every day? | Hebt u zich tijdens de afgelopen 7/14 dagen voortdurend somber of depressief gevoeld gedurende het grootste gedeelte van de dag, en dit bijna elke dag? | COVID25 | COVQ | 18+ |
| In the last 7/14 days have you had the feeling that you've lost interest in or the will to do things you are normally interested in? | Hebt u tijdens de afgelopen 7/14 dagen voortdurend het gevoel gehad nergens meer zin in te hebben of geen interesse meer te hebben voor dingen die u normaal wel interesseren? | COVID26 | COVQ | 18+ |
| Did your appetite change noticeably, or did your weight increase or decrease without this being intended? (in the last 7/14 days) | Was uw eetlust merkbaar veranderd, of is uw gewicht toegenomen of afgenomen, zonder dat dit de bedoeling was? (in de afgelopen 7-14 dagen) | COVID27A | COVQ | 18+ |
| Have you had problems sleeping almost every night (difficulty falling asleep, waking up in the night or too early in the morning, or actually sleeping too much)? (in the last 7/14 days) | Hebt u bijna elke nacht slaapproblemen gehad (moeilijk inslapen, wakker worden tijdens de nacht of te vroeg in de ochtend, of juist teveel slapen)? (in de afgelopen 7-14 dagen) | COVID27B | COVQ | 18+ |
| Did you speak or move more slowly than normal? Or did you feel restless, jittery and could barely sit still? Nearly every day? (in the last 7/14 days) | Praatte of bewoog u trager dan gewoonlijk, of voelde u zich juist rusteloos, gejaagd en kon u moeilijk stil blijven zitten? Bijna elke dag? (in de afgelopen 7-14 dagen) | COVID27C | COVQ | 18+ |
| Did you feel worthless or guilty almost every day? (in the last 7/14 days) | Voelde u zich bijna elke dag waardeloos of schuldig? (in de afgelopen 7-14 dagen) | COVID27D | COVQ | 18+ |
| Was it difficult to concentrate or make decisions almost every day? (in the last 7/14 days) | Kon u zich bijna elke dag moeilijk concentreren of moeilijk beslissingen nemen? (in de afgelopen 7-14 dagen) | COVID27E | COVQ | 18+ |
| Have you considered hurting yourself, wished you were dead, or had suicidal thoughts? (in the last 7/14 days) | Hebt u overwogen zichzelf iets aan te doen, wenste u dat u dood was, of had u zelfmoordgedachten? (in de afgelopen 7-14 dagen) | COVID27F | COVQ | 18+ |
| In the last 7/14 days, have you been worrying excessively and worrying about multiple problems of every day life, at work, at home, in your immediate environment? | Hebt u in de afgelopen 7/14 dagen buitensporig gepiekerd en zich zorgen gemaakt over meerdere problemen van het dagelijks leven, op het werk, thuis, in uw naaste omgeving? (in de afgelopen 7-14 dagen) | COVID28 | COVQ | 18+ |
| Were these worries present almost every day in the last 7/14 days? | Zijn deze zorgen bijna elke dag aanwezig in de afgelopen 7/14 dagen? | COVID28A | COVQ | 18+ |
| In the last 7/14 days did you find it hard to set these worries aside or did they prevent you from concentrating? | Vindt u het moeilijk om deze bezorgdheid in de hand te houden of belemmert dit u om zich te concentreren de afgelopen 7/14 dagen? | COVID28B | COVQ | 18+ |
| You felt restless, jittery or nervous? / In the last 7/14 days did it often happen that… | U zich rusteloos, geladen of zenuwachtig voelde? / Gebeurde het in de afgelopen 7/14 dagen vaak dat… | COVID29A | COVQ | 18+ |
| You felt tense? / In the last 7/14 days did it often happen that… | U zich gespannen voelde? / Gebeurde het in de afgelopen 7/14 dagen vaak dat… | COVID29B | COVQ | 18+ |
| You were particularly irritable? / In the last 7/14 days did it often happen that… | U bijzonder prikkelbaar was? / Gebeurde het in de afgelopen 7/14 dagen vaak dat… | COVID29C | COVQ | 18+ |
Validity of the MINI
Content, criterion, and construct validity as well as reliability of the MINI have been described in various publications 1)2)3).
Rationale for use in Lifelines
Available structured diagnostic interviews for diagnosing psychiatric disorders can be divided into very long interviews developed for research purposes and very short screening tests designed for primary care. The first usually require a trained clinician as an interviewer, whereas the latter require clinician evaluations to follow up on the positive responses. The MINI is in between these types of interviews: it is a relatively short interview that does not require a clinician as an interviewer. It has an appropriate balance between brevity and simplicity on one hand and accuracy on the other.
Derivates
Based on the manual of the MINI (version 5.0.0) derivates are calculated for each diagnosis
. The derivates define whether a participant meets the criteria for a certain diagnosis.
Derivates are available for all Lifelines versions of the MINI. Note that MINI v1 differs significantly from the other versions in that the available derivates pertain to 'last year' instead of 'current' diagnoses and were made in R. For all other versions derivates have been calculated using SPSS syntax.
For the MINI D/v4, items that have been subdivided from the original MINI were rejoined, which made calculations of derivates and comparison with the other versions possible.
Derivates that have been calculated are:
- Current depressive episode
- Lifetime depressive episode
- Current dysthymia
- Current panic disorder without agoraphobia
- Current panic disorder with agoraphobia
- Current agoraphobia without panic disorder
- Lifetime panic disorder
- Current social phobia
- Current generalized anxiety disorder
These derivates should be used to define if a participant meets the criteria (according to the manual of the MINI) for a certain diagnosis.
Publications with Lifelines MINI data
The results of the MINI in the Lifelines cohort are used in a number of published projects
- Naudé, P.J.W., Roest, A.M., Stein, D.J., de Jonge, P., and Doornbos, B. (2018). Anxiety disorders and CRP in a population cohort study with 54326 participants: The LifeLines study. World J. Biol. Psychiatry Off. J. World Fed. Soc. Biol. Psychiatry 1–31.
- Janssens, K.A.M., Zijlema, W.L., Joustra, M.L., and Rosmalen, J.G.M. (2015). Mood and Anxiety Disorders in Chronic Fatigue Syndrome, Fibromyalgia, and Irritable Bowel Syndrome: Results From the LifeLines Cohort Study. Psychosom. Med. 77, 449–457.
- Klijs, B., Kibele, E.U.B., Ellwardt, L., Zuidersma, M., Stolk, R.P., Wittek, R.P.M., Mendes de Leon, C.M., and Smidt, N. (2016b). Neighborhood income and major depressive disorder in a large Dutch population: results from the LifeLines Cohort study. BMC Public Health 16, 773.
- Meurs, M., Roest, A.M., Wolffenbuttel, B.H.R., Stolk, R.P., de Jonge, P., and Rosmalen, J.G.M. (2016). Association of Depressive and Anxiety Disorders With Diagnosed Versus Undiagnosed Diabetes: An Epidemiological Study of 90,686 Participants. Psychosom. Med. 78, 233–241.
- Zijlema, W.L., Wolf, K., Emeny, R., Ladwig, K.H., Peters, A., Kongsgård, H., Hveem, K., Kvaløy, K., Yli-Tuomi, T., Partonen, T., et al. (2016c). The association of air pollution and depressed mood in 70,928 individuals from four European cohorts. Int. J. Hyg. Environ. Health 219, 212–219.
- Nigatu, Y.T., Reijneveld, S.A., Jonge, P. de, Rossum, E. van, and Bültmann, U. (2016). The Combined Effects of Obesity, Abdominal Obesity and Major Depression/Anxiety on Health-Related Quality of Life: the LifeLines Cohort Study. PLOS ONE 11, e0148871.
- Lugtenburg, A., Voshaar, O., C, R., Van Zelst, W., Schoevers, R.A., Enriquez-Geppert, S., and Zuidersma, M. (2017). The relationship between depression and executive function and the impact of vascular disease burden in younger and older adults. Age Ageing 1–5.
- van Loo, H.M., Schoevers, R.A., Kendler, K.S., de Jonge, P., and Romeijn, J.-W. (2016). Psychiatric Comorbidity Does Not Only Depend on Diagnostic Thresholds: An Illustration with Major Depressive Disorder and Generalized Anxiety Disorder. Depress. Anxiety 33, 143–152.
- Gulpers, B., Lugtenburg, A., Zuidersma, M., Verhey, F.R.J., and Voshaar, R.C.O. (2018). Anxiety disorders and figural fluency: A measure of executive function. J. Affect. Disord. 234, 38–44.
- Deschênes, S.S., Burns, R.J., and Schmitz, N. (2018). Comorbid depressive and anxiety symptoms and the risk of type 2 diabetes: Findings from the Lifelines Cohort Study. J. Affect. Disord. 238, 24–31.
- Kuiper, J.S., Oude Voshaar, R.C., Verhoeven, F.E.A., Zuidema, S.U., and Smidt, N. (2017). Comparison of cognitive functioning as measured by the Ruff Figural Fluency Test and the CogState computerized battery within the LifeLines Cohort Study. BMC Psychol. 5, 15.
- Wanders, R.B.K., van Loo, H.M., Vermunt, J.K., Meijer, R.R., Hartman, C.A., Schoevers, R.A., Wardenaar, K.J., and de Jonge, P. (2016). Casting wider nets for anxiety and depression: disability-driven cross-diagnostic subtypes in a large cohort. Psychol. Med. 46, 3371–3382.
