Toward Optimal Treatment for Schizophrenia and Co-Occurring Alcohol Use Disorder:

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DESCRIPTION (provided by applicant): Patients with schizophrenia (SCZ) have elevated rates of substance use disorders (SUD) relative to the general population, most prominently for alcohol, nicotine and cannabis. Co-occurring alcohol use disorder (AUD) in SCZ is associated with increased symptoms, violence and victimization, homelessness, institutionalization, and poorer overall outcome of SCZ. Despite the prevalence and ramifications of AUD (and other SUDs) in SCZ, effective treatments for co-occurring AUD/SUD in patients with SCZ are limited. Many theoretical models, including biological, cognitive or psychosocial, have been discussed in an attempt to explain the increased prevalence of such co-occurring disorders in SCZ and to guide treatments. There have been few attempts, however, to integrate these models into a unified theory of the basis of alcohol and other SUD in patients with SCZ - a theory that could be tested over time and one that might lead to development of new treatment strategies. If better treatments are to be developed, the creation of integrative theoretical and practical models of the basis of these co-occurring disorders is essential. We propose a conference to bring together a multi-disciplinary group of scientists and scientist-practitioners whose research is based on (or informs) biological, cognitive, and/or psychosocial models of etiology and treatment of AUD, SCZ, and of co-occurring AUD/SUD in SCZ. Visiting scientists, both expert and junior, will join with Dartmouth faculty to present their research and related literature. A series of discussions led by the conference chairs will seek to integrate these presentations, find theoretical bridges between the domains, and foster the development of testable hypotheses to empirically evaluate integrative models of AUD in SCZ. Thus, the specific aims of this conference will be: (1) To describe the prevalence and phenomenology of co- occurring AUD in SCZ; (2) to explain and integrate biological, cognitive and psychosocial etiological theories of co-occurring AUD/SUD in SCZ; (3) to describe current and potentially effective pharmacological, psychological, behavioral, social and environmental interventions for co-occurring AUD and SCZ; and (4) to propose new therapeutic approaches based on theoretical models to explain the co-occurrence of AUD/SUD in SCZ. PUBLIC HEALTH RELEVANCE: Co-occurring alcohol (and other substance) use disorder is common in patients with schizophrenia and contributes to a poor outcome for those with this severe psychiatric disorder. Current treatment approaches have only limited effectiveness for such patients. This Conference will gather experts in the field to integrate existing theories related to the basis of alcohol (and other substance use) disorder in schizophrenia, and based on this integration, will develop new treatment approaches aimed at improving outcomes for these difficult to treat patients.