Higher Depression Diagnosis With MINI Than SCID

The Mini International Neuropsychiatric Interview (MINI) diagnoses more people with major depression than the Structured Clinical Interview for DSM (SCID) in studies that use the Hospital Anxiety and Depression Scale (HADS-D), according to an analysis of depression diagnostic interviews published in the Journal of Psychosomatic Research.

Both the MINI and Composite International Diagnostic Interview (CIDI) are fully structured interviews that are commonly used to classify patients with major depression. Conversely, the SCID is a semi-structured interview typically administered by a healthcare professional. The MINI and CIDI may not provide similar classification results as the SCID.

This individual participant data meta-analysis (IPDMA) examined patterns between the MINI, SCID, and CIDI diagnostic interviews with the percentage of individuals classified as having major depression. Specifically, these patterns were assessed only in studies that used the HADS-D. Researchers performed a literature review to identify datasets that reported diagnostic classification for major depression and included total scores for the HADS-D. A total of 73 datasets encompassing 15,856 participants (12% with major depression) were included in the analysis. There were 36 SCID studies, 10 CIDI studies, and 27 MINI studies.

When researchers controlled for HADS-D scores, the MINI demonstrated a greater likelihood of classifying participants as having major depression compared with the CIDI (adjusted odds ratio [aOR], 1.70; 95% CI, 0.84-3.43). Despite this higher likelihood, the investigators reported some imprecision in the estimates. The MINI more often classified participants as having major depression than the SCID (aOR, 1.52; 95% CI, 1.01-2.30). There was no difference between the CIDI and the SCID for the odds of major depression classification (aOR, 1.09; 95% CI, 0.56-2.13).

In addition, the odds of classifying participants with major depression increased more for MINI than CIDI with stepwise increases in HADS-D scores (interaction aOR, 1.07; 95% CI, 1.03-1.12). These odds increased less for the CIDI compared with the SCID (interaction aOR, 0.92; 95% CI, 0.88-0.96). The analysis found no significant interaction for the comparison between the MINI and SCID (interaction aOR, 0.99; 95% CI, 0.96-1.02).

A study limitation was the inclusion of datasets that had few participants with high-end HADS-D scores, which may limit the generalizability across patient groups who score high on this subscale. The investigators concluded that researchers “should take into consideration the advantages and disadvantages of different diagnostic interviews, including resources required to use each of them, when choosing different instruments and interpreting findings.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Wu Y, Levis B, Sun Y, et al. Probability of major depression diagnostic classification based on the SCID, CIDI and MINI diagnostic interviews controlling for Hospital Anxiety and Depression Scale – Depression subscale scores: An individual participant data meta-analysis of 73 primary studies [published online December 13, 2019]. J Psychosom Res. doi:10.1016/j.jpsychores.2019.109892