Mini International Neuropsychiatric Interview

The Mini International Neuropsychiatric Interview (MINI) (section: mental health) was performed in all adult Lifelines participants during:

• 1A Visit 1 (as interview, n = ~149.000, 65+ participants 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)

Note that MINI derivatives were calculated to assess whether participants meet the criteria for certain psychiatric diagnoses.

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 assessments DEPQ and DEAQ were performed to assess lifetime mood-related episodes (using the 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

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:

1. some questions differ in the reference period on which the complaint/syndrome should be reported;
2. some questions are differently phrased;
3. some questions differ in content;
4. 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.

In April 2020, an additional assessment (COVQ) was started to measure the effects of the 2020 Corona crisis on (amongst others) the mental health of Lifelines participants using items adapted from the MINI.

Content, criterion, and construct validity as well as reliability of the MINI have been described in various publications ¹⁾²⁾³⁾.

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.

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.