Bipolar disorder is a dynamic illness with constantly changing symptom and syndrome presentations thatconfound interpretation of neuroimaging findings, as well as treatment response. This feature of the illnessraises the need to examine patients as the condition evolves over time in order to clarify interactionsbetween neuroimaging measures, clinical response and affective state. Careful longitudinal assessmentsand subject retention are critical elements to the success of the BITREC and its proposed projects. TheLongitudinal Assessment Core (LAC) will serve this need and is a direct extension of over a decade ofexperience following young bipolar patients. Specifically, our experience with longitudinal studies isdemonstrated by the success of a number of large, long-term projects. Our previous and ongoing projectsprovide an infrastructure for the longitudinal study of bipolar disorder from which the LAC will be developed.The LAC will be fully integrated with the other BITREC cores and projects as described in the OperationalPlan. Dr. Paul Keck, Professor of Psychiatry and Pharmacology and Vice-Chair for Research in theDepartment of Psychiatry will direct the LAC. He will be responsible for overall core function and foroverseeing infrastructure development. He will be assisted by several clinicians and staff to provide excellentclinical care and ongoing assessments to subjects enrolled in the BITREC. The LAC will hold staff meetingsevery other week to ensure that recruitment benchmarks are being met and to review subjects who havedeveloped new affective episodes or symptoms in order to determine whether they qualify for additionalBITREC projects. Standard operating procedures will be developed to maximize efficiency and meetobjectives and benchmarks. Most decisions involving daily core function will be made by the personnel of thecore under the direction of Dr. Keck. These decisions will be guided by and reported to the BITREC SteeringCommittee. Additionally, Dr. Keck will be integrated within the overall administrative structure of the BITRECby serving on the Steering Committee. With this structure established the LAC will be able to meet itsprimary functions which are: 1) to provide treatment to subjects actively participating in BITREC projects;2) to provide ongoing clinical evaluations and excellent clinical care to subjects enrolled in the BITRECbetween projects; and 3) to identify subjects who meet criteria for a new BITREC project. By following andmanaging subjects across project, the LAC helps to further integrate the various components of the BITREC,assuring a cohesive and effective research center.
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