How the Mini actually works when you're not reading a manual
The Mini International Neuropsychiatric Interview 70 is a structured diagnostic tool that maps DSM-5 and ICD-10 criteria into a series of yes-or-no modules. It takes about 15 to 20 minutes to administer if the patient is cooperative. You go through each module, ask the questions in order, record the responses, and the scoring rules tell you whether the criterion is met. That is the basic flow. It sounds simpler than it is. The 7.0 version covers fifteen modules covering major depression, mania, bipolar disorder, panic disorder, agoraphobia, social phobia, post-traumatic stress, obsessive-compulsive disorder, somatoform disorders, alcohol dependence, drug dependence, psychosis, dysthymia, eating disorders, and ADHD. Each module has its own branching logic. Positive screen on a severity question can trigger additional follow-up items. Missing a branch point is how most scoring errors happen. One thing beginners miss is that the Mini is designed for screenin g, not for detailed phenomenological assessment. It can confirm a diagnosis in a research setting with reasonable sensitivity. It is not a substitute for a full clinical interview when treatment decisions are on the line. The developers state this clearly in the manual, but people still try to use it as a complete diagnostic workup. It does not capture subthreshold symptoms well. Cultural idioms of distress often do not map onto the question wording. You will see this in primary care settings where patients describe somatic complaints that the anxiety or depression modules simply do not ask about.
Practical administration workflow
Get the questionnaire from the official publisher. The French version by Sheehan and Lecrubier is the source. Most users license it through their institution. There is no legitimate free version that covers the full 7.0 scope without going through the proper copyright channel. If someone gives you a PDF with no license attached, it is likely pirated. Using unlicensed versions in a research setting will get your IRB review rejected or your data thrown out. Here is how I set up a typical administration. I print or load the interview on a tablet. I read each question exactly as written. I do not rephrase. The scoring depends on the exact wording. I record the answer immediately. If the patient hesitates, I wait. I do not prompt. The pause is part of the data. I skip any module where the exclusion criteria are met before starting. This happens most often with substance-related modules where a medical condition explains the symptoms. The branching logic is where things get messy in practice. Module H on alcohol dependence asks about tolerance, withdrawal, and loss of control. But the question about "larger amounts or over a longer period" assumes the patient will self-report quantity. Many patients will say they only drink on weekends and miss the weekly volume question entirely. I learned this the hard way. A participant scored negative for dependence on the initial pass, then I went back and recalculated the standard drinks per occasion. The correct score was positive. Recalculating after the fact is not how the interview is supposed to work. It introduces scorer drift. The workaround I use now is to ask for a typical week before opening the module, so the quantity anchor is already in place. It adds roughly ninety seconds to the interview but prevents that kind of scoring error.
Scoring and reliability considerations
The Mini has established inter-rater reliability coefficients in the 0.80 to 0.95 range across most modules when raters are trained. Training is not optional. Watching a video once does not prepare you. The official training packet runs about three hours and includes practice interviews with feedback. Without it, you will miss branch points and misinterpret severity criteria. I have seen trained clinicians disagree on a single module because one interpreted "marked impairment" differently than the other. The manual acknowledges this variance. It does not eliminate it. One counter-intuitive point: the Mini tends to over-identify substance use disorders in populations with high comorbidity. The alcohol and drug modules are scored independently, which means a patient can screen positive for both even when the presentation is a single polysubstance pattern. The separate scoring is intentional for research purposes but it creates noise in clinical settings where you need a unified substance diagnosis. If you are using this for treatment planning rather than research, consider running a timeline follow-back alongside the Mini to untangle the patterns.
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Known limitations
The Mini International Neuropsychiatric Interview 70 does not cover personality disorders. It also has limited coverage of eating disorders beyond binge eating and bulimia. The PTSD module is brief and may miss complex trauma presentations. It is not validated for use in children under eighteen. Some modules perform poorly in low-literacy populations because the questions assume a certain reading level. In my experience, the OCD module is the most variable across different languages and translations. The Portuguese and Spanish versions have known differences in how compulsions are framed compared to the original English. If you are running a multi-site study, test the translation before you collect data. A bad translation can inflate or deflate prevalence estimates by twenty percent or more. Another limitation is the rigid time window. Most modules use a lifetime or twelve-month criterion. If your study population has episodic conditions with long remission periods, the Mini will undercount. I ran a study where the depression module missed cases because participants had been symptom-free for fourteen months. The criterion window was twelve months. Those cases would have been captured with a six-month window, but the instrument does not allow that variation. This is a design constraint, not a bug. It is worth noting if your population has chronic episodic conditions.
Where to get it
The official Mini is available through the web site of David Sheehan at the University of South Florida. Licensing is typically handled by the publisher. There are also institutional licensing options through academic publishers. Make sure you are getting version 7.0 and not an older edition. The scoring rules changed between version 5.0 and 7.0, especially in the PTSD and OCD modules. Using an outdated version in a new study will make your data incompatible with current DSM-5 standards. If you need something free for exploratory work, the MINI Plus is available in the public domain for some uses, but check the license terms carefully. It is not identical to the 7.0 and lacks some of the updated severity items. For anything going to peer review or regulatory submission, the licensed 7.0 is the standard.
Final notes on usage
The Mini is a tool, not a diagnosis engine. It gives you a structured way to apply diagnostic criteria. It does not replace clinical judgment. Use it when you need a quick, validated screen across multiple disorders. Do not use it when you need a detailed phenotypic profile. The time savings are real. A full SCID interview can take forty-five to ninety minutes. The Mini gets you comparable diagnostic accuracy in a fraction of that time. Just be aware of where the trade-offs sit and plan your study or clinical workflow accordingly. That is about all there is to it.
