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In the present study, the MINI is applied to assess the prevalence and severity of depression . The MINI is a short, structured diagnostic interview for the assessment of psychiatric disorders that was developed in the 1990s for use in primary care. The MINI represents a new approach to diagnosing mental health disorders in primary care. The MINI was designed to be easy to administer in a busy clinical practice and to provide reliable and valid diagnoses. The MINI’s reliability is high, with Cohen’s kappa ranging from 0.61 to 0.92 . The MINI allows for the simultaneous assessment of symptoms and diagnosis of cases of major depression, dysthymia, minor depression, anxiety disorders, substance abuse and dependence, and eating disorders. The MINI is administered by a trained interviewer using a structured interview guide. The interview takes around 30–40 minutes to complete. The diagnostic algorithm used in the MINI is presented in Table 1. The diagnosis of major depression is reached when the patient reports at least five of the following symptoms in the past one month:
The severity of depression is classified according to Montgomery and Asberg’s method: mild (13–14), moderate (15–18), severe (19–20), and extremely severe (21–22). Although depression is diagnosed when one or more of the above symptoms are present, it is necessary to assess each case with the structured clinical interview, even if the patient only experiences mild symptoms of depression. The classification of each case was performed independently by two psychiatrists who specialized in the assessment of depression. To reduce the risk of a misdiagnosis of depression, the MINI, which is considered a reliable diagnostic tool, was administered by two psychiatrists. The MINI is currently in use in major cities in Brazil, including all the three primary health care units, as well as all of the major hospitals in Curitiba. This tool was used to assess the participation of patients and their families in the intervention, as well as the adherence to the exercise program, with the hypothesis that the adherence to the exercise program would be greater among those who showed improvement in the MINI. Participants were also asked about their adherence to the intervention in the questionnaires.
The following data were collected by the interview: age, sex, race, socioeconomic status (SES), use of tobacco and alcohol, and previous diagnosis of COPD (current or past), as well as information on the use of the drug bupropion at the time of the interview. The drug was initially used as an antidepressant, but now is used off-label in the treatment of depression in patients with COPD. The presence of psychiatric symptoms in the last 15 days was assessed using the MINI-KID-S, from which the following were evaluated: the presence of depression (major depressive disorder (MDD) or dysthymic disorder), the presence of psychosis, and the use of antipsychotic drugs.
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