The Clinical Evaluation Core (CEC) goals are: 1) Recruitment, characterization and retention of human subjects; 2) Uniform diagnostic method and clinical assessment battery across all projects; 3) Methods development; 4) Maintenance of reliability among clinical raters; 5) Supervise inpatient study phase and conduct outpatient study; 6) Consultation to investigators; and 7) Obtaining Biomarker Specimens for Analysis. The CEC recruits depressed patients and healthy controls and identifies 4 post-mortem groups of cases: suicides and non-suicides, each with and without early life adversity. The CEC conducts clinical evaluation, data collection and treatment for patients in all Conte Center projects that include human subjects, utilizing a core of clinical instruments covering major symptom domains for suicide risk, and ensuring uniformity of assessment and measures across the projects of the Conte Center. Assessments include structured diagnostic interviews, measures of state and trait risk factors, measures of suicidal behavior, demographics, life events, social functioning, family history, emotion regulation, cognition, and sickness behaviors. Assessments are performed at intake, at time of biological procedures, and at discharge. The CEC conducts diagnostic consensus conference and maintains inter-rater reliability for human subjects projects. The CEC interacts extensively with other Cores and Projects in the Conte Center: 1) with the Database and Statistics Core 4 and the Statistical Models Project 6 to maintain quality control of data management procedures and rater reliability statistics; 2) with Neuroimaging Projects 3 and 4 to perform subject recruitment, clinical interviewing, matching controls and monitoring drug washouts and subject flow through the brain imaging protocols; 3) to conduct psychological autopsy assessments of the individuals whose postmortem brains are studied in Project 1, Neurobiology of Suicide; 4) to obtain all biospecimens including blood and saliva to be analyzed by the Neurobiology and Genomics Laboratory Core 3; and 5) with the Administrative Core 1 to manage staffing, maintain a central database of CEC manuscripts, and provide supervision for trainees in clinical and laboratory research methods. CEC Project Leaders and Investigators comprise an experienced center structure as most have worked together as a team for over 10 years. The seasoned clinicians in the CEC have expertise in caring for patients at high suicide risk and offer both inpatient and outpatient treatment to optimize patient safety. CEC contributions to new approaches proposed in this renewal include assessment of sickness behaviors and collecting biospecimens for measurement of the inflammasome.
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