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Open Access Research article

Saving time and money: a validation of the self ratings on the prospective NIMH life-chart method (NIMH-LCM)

Christoph Born1*, Benedikt L Amann23, Heinz Grunze4, Robert M Post5 and Lars Schärer6

Author Affiliations

1 Department of Psychiatry, Ludwig Maximilians-University, Nußbaumstr. 7, Munich 80336, Germany

2 FIDMAG Research Foundation Germanes Hospitalàries, Barcelona, Spain

3 CIBERSAM, Barcelona, Spain

4 Institute of Neuroscience, Newcastle University, Newcastle, UK

5 Bipolar Collaborative Network, Bethesda, MD, USA

6 Department of Psychiatry, Albert Ludwig-University, Freiburg, Germany

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BMC Psychiatry 2014, 14:130  doi:10.1186/1471-244X-14-130

Published: 7 May 2014

Abstract

Background

Careful observation of the longitudinal course of bipolar disorders is pivotal to finding optimal treatments and improving outcome. A useful tool is the daily prospective Life-Chart Method, developed by the National Institute of Mental Health. However, it remains unclear whether the patient version is as valid as the clinician version.

Methods

We compared the patient-rated version of the Lifechart (LC-self) with the Young-Mania-Rating Scale (YMRS), Inventory of Depressive Symptoms–Clinician version (IDS-C), and Clinical Global Impression–Bipolar version (CGI-BP) in 108 bipolar I and II patients who participated in the Naturalistic Follow-up Study (NFS) of the German centres of the Bipolar Collaborative Network (BCN; formerly Stanley Foundation Bipolar Network). For statistical evaluation, levels of severity of mood states on the Lifechart were transformed numerically and comparison with affective scales was performed using chi-square and t tests. For testing correlations Pearson´s coefficient was calculated.

Results

Ratings for depression of LC-self and total scores of IDS-C were found to be highly correlated (Pearson coefficient r = −.718; p < .001), whilst the correlation of ratings for mania with YMRS compared to LC-self were slightly less robust (Pearson coefficient r = .491; p = .001). These results were confirmed by good correlations between the CGI-BP IA (mania), IB (depression) and IC (overall mood state) and the LC-self ratings (Pearson coefficient r = .488, r = .721 and r = .65, respectively; all p < .001).

Conclusions

The LC-self shows a significant correlation and good concordance with standard cross sectional affective rating scales, suggesting that the LC-self is a valid and time and money saving alternative to the clinician-rated version which should be incorporated in future clinical research in bipolar disorder. Generalizability of the results is limited by the selection of highly motivated patients in specialized bipolar centres and by the open design of the study.

Keywords:
Bipolar disorders; Mania; Depression; Long-term course; Life-chart