Comorbidity: Substance Use Disorders and Other Psychiatric Conditions

描述(由申请者提供)：长期目标：在目前由NIDA资助的培训赠款组合中，没有一项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(例如糖尿病)共存的流行率，以及在传统治疗环境中SUD或共病障碍可能得不到或得不到治疗的程度，这一点令人震惊。加强研究专门知识以改进诊断、治疗和预防战略至关重要。拟议的计划将培养一支在共病机制、先兆和相关性、诊断学以及心理社会和药理学干预方面具有研究专长的科学家队伍。构成部分的目标是向每个受训人员提供共病研究的实用知识，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)针对人口和族裔和文化群体(例如美国印第安人、苗族、索马里人)的共病情况的有效研究战略。完成计划功能将利用(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)拥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。主要地点(4名博士后实习生，每个2年)是精神病学系(UMN双城)和生物行为健康与人口科学(UMN Duluth)，由心理学系(UMTC)和其他UMN实体支持；(2)招募，包括在代表下的团体外联，招募严格筛选的博士和MD候选人，以SUD和合并症为主要职业重点；(3)与具有互补专业知识的跨学科指导小组(初级和2名二级导师)进行培训；(4)具有明确里程碑的正式培训计划，包括学员在第一年开始开发NIH申请；(5)积极的研究、研讨会、授课工作、讲习班，以及管理、道德和监管专业知识的发展；(6)动态的计划管理，包括加强监测和解决问题，并在完成后与受训者继续联系；(7)每年召开外部咨询小组。资源：导师的资金来源包括NIH研究所、NSF、明尼苏达医学基金会和制药业。关键人员和主要导师是拥有大量资源的诊所、中心或部门的主任。该计划侧重于培训学员在SUD与精神障碍(焦虑、ADHD、边界、进食、抑郁、精神分裂症、创伤)共存方面的专业知识。

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).