Denicoff K D, Leverich G S, Nolen W A, Rush A J, McElroy S L, Keck P E, Suppes T, Altshuler L L, Kupka R, Frye M A, Hatef J, Brotman M A, Post R M
Biological Psychiatry Branch, NIMH, NIH and Stanley Foundation Bipolar Network, NAMI Research Institute, Bethesda, MD 20892-1272, USA.
Psychol Med. 2000 Nov;30(6):1391-7. doi: 10.1017/s0033291799002810.
Systematic and accurate depiction of a patient's course of illness is crucial for assessing the efficacy of maintenance treatments for bipolar disorder. This need to rate the long-term prospective course of illness led to the development of the National Institute of Mental Health prospective Life Chart Methodology (NIMH-LCM-p or LCM). The NIMH-LCM-p allows for the daily assessment of mood and episode severity based on the degree of mood associated functional impairment. We have previously presented preliminary evidence of the reliability and validity of the LCM, and its utility in clinical trials. This study is a further and more extensive validation of the clinician rated NIMH-LCM-p.
Subjects included 270 bipolar patients from the five sites participating in the Stanley Foundation Bipolar Network. Daily prospective LCM ratings on the clinician form were initiated upon entry, in addition to at least monthly ratings with the Inventory of Depressive Symptomatology-clinician rated (IDS-C), the Young Mania Rating Scale (YMRS) and the Global Assessment of Functioning (GAF). We correlated appropriate measures and time domains of the LCM with the IDS-C, YMRS and GAF.
Severity of depression on the LCM and on the IDS-C were highly correlated in 270 patients (r = -0.785, P < 0.001). Similarly, a strong correlation was found between LCM mania and the YMRS (r = 0.656, P < 0.001) and between the LCM average severity of illness and the GAF (r = -0.732, P < 0.001).
These data further demonstrate the validity and potential utility of the NIMH-LCM-p for the detailed daily longitudinal assessment of manic and depressive severity and course, and response to treatment.
系统且准确地描述患者的病程对于评估双相情感障碍维持治疗的疗效至关重要。这种对疾病长期前瞻性病程进行评分的需求促使美国国立精神卫生研究所前瞻性生命图表方法（NIMH-LCM-p或LCM）得以发展。NIMH-LCM-p允许根据与情绪相关的功能损害程度对情绪和发作严重程度进行每日评估。我们之前已经展示了LCM可靠性和有效性的初步证据，以及其在临床试验中的效用。本研究是对临床医生评定的NIMH-LCM-p进行的进一步且更广泛的验证。
研究对象包括来自参与斯坦利基金会双相情感障碍网络的五个地点的270名双相情感障碍患者。除了至少每月使用临床医生评定的抑郁症状量表（IDS-C）、杨氏躁狂量表（YMRS）和功能总体评定量表（GAF）进行评分外，患者入组时即开始使用临床医生表格进行每日前瞻性LCM评分。我们将LCM的适当测量指标和时间域与IDS-C、YMRS和GAF进行了相关性分析。
270名患者中，LCM上的抑郁严重程度与IDS-C上的抑郁严重程度高度相关（r = -0.785，P < 0.001）。同样，LCM上的躁狂与YMRS之间（r = 0.656，P < 0.001）以及LCM上的疾病平均严重程度与GAF之间（r = -0.732，P < 0.001）也发现了强相关性。
这些数据进一步证明了NIMH-LCM-p在详细每日纵向评估躁狂和抑郁严重程度、病程及治疗反应方面的有效性和潜在效用。
