Utility of the daily prospective National Institute of Mental Health Life-Chart Method (NIMH-LCM-p) ratings in clinical trials of bipolar disorder
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This study investigated the assets of the daily prospective National Institute of Mental Health Life-Chart Method (NIMH-LCM-p or LCM-p) for use in clinical trials in bipolar disorder. Fifty-two outpatients, who met DSM-III-R criteria for bipolar disorder, were randomly assigned in a double-blind design to an intended 1 year of treatment with lithium or carbamazepine, a crossover to the opposite drug in the second year, and then to a combination of both agents in the third year. For each patient, the LCM-p was initiated upon admission and was continued on a daily basis. Overall therapeutic effect for each phase (intended year) was assessed by using the Clinical Global Impressions-Bipolar Version (CGI-BP) scale. Kruskal-Wallis analysis of variance was used to examine the detailed course-of-illness variables derived from the LCM-p (e.g., percentage of time ill, average severity of illness, episodes per year, and mood switches per year) in relation to the global assessments of treatment response (CGI-BP). Most of the individual LCM-p-derived illness variables varied significantly (P <.05) as a function of global treatment response. Since global ratings of the degree of improvement can represent very different proportions of improvement in percentage of time ill, average severity of mania or depression, or frequency of manic and depressive episodes, the LCM-p provides the basis for a comprehensive description of both the illness course and the response to treatment. The LCM-p appears to have considerable utility in clinical trials of pharmacological and other interventions of bipolar disorder. It provides a detailed characterization of the severity, frequency, and duration of manic and depressive episodes, which facilitates the assessment of global improvement and allows for the quantification of separate components of the illness, which are or are not responsive to a given treatment.
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Daily recording of mood symptoms such as through a mood diary or NIMH Life Chart Method-Self Rating Scale can help identify early warning signs of relapse and outline relationships between mood and treatment or lifestyle factors.
“For many patients, daily recording of mood symptoms such as through a mood diary or National Institute of Mental Health (NIMH) Life Chart Method‐Self Rating Scale can help identify early warning signs of relapse, as well as outline relationships between mood and treatment or lifestyle factors such as diet, exercise, or stress.64”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [64]
The Method describes daily patient-rated life charts, and the Discussion says the LCM-p can reveal changes in treatment response and notes that minor episodes may herald fuller episodes. This supports tracking mood and treatment patterns and, to a limited extent, warning signs. The paper does not establish that mood diaries help many patients identify relapse early or link mood to lifestyle factors such as diet, exercise, or stress. (LLM, conf=0.85)
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References 28 · Cited by 59
Research works printed but not linked: 4
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- Authors
- Denicoff, K. D., Ali, S. O., Sollinger, A. B., Smith-Jackson, E. E., Leverich, G. S., & Post, R. M.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Denicoff, Kirk D.
- ORCID
- Post, Robert M.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2002
- Volume
- 15
- Issue
- 1
- Pages
- 1-9
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2026774743
- Cited by
- 59
- References
- 28
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 1 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 1 · 2015: 3 · 2014: 4 · 2013: 4
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, clinical course, treatment response assessment, lithium, carbamazepine, manic episodes, depressive episodes, clinical trial outcome measures
- MeSH terms
- Adult, Aged, Anticonvulsants, Bipolar Disorder, Carbamazepine, Double-Blind Method, Drug Resistance, Drug Therapy, Combination, Female, Humans, Lithium, Male, Middle Aged, Prospective Studies, Cross-Over Studies, Antimanic Agents
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