Comorbidity: Substance Use Disorders and Other Psychiatric Conditions

描述（由申请人提供）：长期目标：在目前NIDA资助的培训补助金组合中，没有一个将合并症作为主要重点。考虑到物质使用障碍（SUD）与其他精神疾病和健康状况（如糖尿病）的共同患病率，以及在传统治疗环境中，SUD或共病障碍可以不治疗或不治疗的程度，这是令人震惊的。加强研究专门知识以改进诊断、治疗和预防战略至关重要。该计划将培养一批在共病机制、前因和相关因素、诊断以及社会心理和药理学干预方面具有研究专长的科学家。组成部分的目标是为每个学员提供共病研究的工作知识，包括：(a)从早期临床试验到基于社区的参与性研究视角的转化科学；(b)针对不同人口、种族和文化群体（如美洲印第安人、苗族、索马里人）的合并症的有效研究战略。实现计划性特征将充分利用(a)跨多个领域提供指导的教师专业知识范围，以及(b)跨培训计划和部门的整合。关键要素：(1)具有不同专业知识的科学家和临床医生的参与，以及一个核心的内部咨询小组。主要站点（4名博士后学员，各2年）是精神病学（UMN双城）和生物行为健康与人口科学系（UMN德卢斯），由心理学系（UMTC）和其他UMN实体提供支持；(2)招聘，包括代表性不足的团体外展，严格筛选以SUD和合并症为主要职业重点的博士和医学博士候选人；(3)与专业互补的跨学科指导团队（初级导师和2名二级导师）进行培训；(4)有明确里程碑的正式培训计划，包括学员在第一年开始的NIH申请的发展；(5)积极开展研究、研讨会、教学课程工作、研讨会以及管理、道德和监管专业知识的发展；(6)动态项目管理，包括监控、改进和问题解决，以及在项目完成后与学员的持续联系；(7)每年召开一次外部咨询小组会议。资源：导师的资金来源包括美国国立卫生研究院、美国国家科学基金会、明尼苏达医学基金会和制药行业。关键人员和主要导师是拥有重要资源的诊所、中心或部门的主任。该项目侧重于培训学员在SUD与精神疾病（焦虑、多动症、边缘型人格障碍、饮食失调、抑郁症、精神分裂症、创伤）共发方面的专业知识。

DESCRIPTION (provided by applicant): Long-term goals: Among the current portfolio of NIDA funded training grants, none have comorbidity as a primary focus. This is striking given co-occurrence prevalence of Substance Use Disorders (SUD) with other psychiatric conditions and health conditions (e.g. diabetes), and the extent to which either SUD or the comorbid disorder can go under- or untreated in conventional treatment settings. Enhancing research expertise to improve diagnostic, treatment and prevention strategies is essential. The proposed program will develop a cadre of scientists with research expertise in comorbidity mechanisms, antecedents and correlates, diagnostics, and psychosocial and pharmacological interventions. Component objectives are to provide each trainee with a working knowledge of comorbidity research including: (a) translational science from Early Phase Clinical Trials to Community Based Participatory Research perspectives; (b) effective research strategies for comorbid conditions across populations and ethnic and cultural groups (e.g. American Indian, Hmong, Somali). Accomplishing programmatic features will capitalize on (a) the spectrum of faculty expertise providing mentoring across multiple areas, and (b) integration across training programs and departments. Key Elements: (1) Involvement of scientists and clinicians with diverse expertise and a core internal advisory group. Primary sites (4 postdoctoral trainees, 2 yrs each) are the Departments of Psychiatry (UMN Twin Cities) and Biobehavioral Health & Population Science (UMN Duluth), supported by the Psychology Department (UMTC) and other UMN entities; (2) Recruitment, including under represented group outreach, of rigorously screened PhD and MD candidates with SUD and comorbidity as primary career focus; (3) Training with an interdisciplinary mentoring team (primary & 2 secondary mentors) with complementary expertise; (4) Formal training plans with clear milestones including trainee development of an NIH application initiated in Year 1; (5) Active research, seminars, didactic course work, workshops, and development of management, ethics, and regulatory expertise; (6) Dynamic program administration entailing monitoring with enhancements and problem resolution along with continued contact with trainees after completion and; (7) Annually convened external advisory group. Resources: Mentor funding sources include NIH Institutes, NSF, Minnesota Medical Foundation, and pharmaceutical industry. Key Personnel and Primary Mentors are directors of clinics, centers, or departments with significant resources. The program focuses on trainee expertise in SUD co-occurring with psychiatric disorders (Anxiety, ADHD, Borderline, Eating, Depression, Schizophrenia, Trauma).