Background. 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-LCMTM-p or LCM). The NIMH-LCMTM-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-LCMTM-p.
Methods. 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.
Results. 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).
Conclusions. These data further demonstrate the validity and potential utility of the NIMH-
LCMTM-p for the detailed daily longitudinal assessment of manic and depressive severity and
course, and response to treatment.