Validation of the prospective NIMH-Life-Chart Method (NIMH-LCM (TM)-p) forlongitudinal assessment of bipolar illness

Background. Systematic and accurate depiction of a patient's course of illn ess is crucial for assessing the efficacy of maintenance treatments for bip olar disorder. This need to rate the longterm prospective course of illness led to the development of the National Institute of Mental Health prospect ive Life Chart Methodology (NIMH-LCMTM-p or LCM), The NIMH-LCMTM-p allows f or the daily assessment of mood and episode severity based on the degree of mood associated functional impairment. We have previously presented prelim inary evidence of the reliability and validity of the LCM, and its utility in clinical trials. This study is a further and more extensive validation o f the clinician rated NIMH-LCMTM-p. Methods. Subjects included 270 bipolar patients from the five sites partici pating in the Stanley Foundation Bipolar Network. Daily prospective LCM rat ings on the clinician form were initiated upon entry, in addition to at lea st monthly ratings with the Inventory of Depressive Symptomatology-clinicia n rated (IDS-C), the Young Mania Rating Scale (YMRS) and the Global Assessm ent of Functioning (GAF). We correlated appropriate measures and time domai ns of the LCM with the IDS-C, YMRS and GAF. Results. Severity of depression on the LCM and on the IDS-C were highly cor related in 270 patients (r = -0.785, P < 0.001). Similarly, a strong correl ation was found between LCM mania and the YMRS (r = 0.656, P < 0.001) and b etween the LCM average severity of illness and the GAF (r = -0.732, P < 0.0 01). Conclusions. These data further demonstrate the validity and potential util ity of the NIMH-LCMTM-p for the detailed daily longitudinal assessment of m anic and depressive severity and course, and response to treatment.