MI for Teen Substance Abuse with Psychiatric Comorbidity

描述（由申请人提供）： 患有物质使用障碍的青少年经常患有伴随的精神障碍。不幸的是，尽管这种共病的精神病理学的有害后果，青少年精神病治疗的物质使用问题往往没有得到充分的评估或解决。本研究项目的总体目标是开发有效的简短干预方法，以解决患有精神疾病的高危青少年的物质使用问题，并在治疗结果研究的背景下，提高我们对精神疾病和物质使用障碍之间关系的认识。 拟议的研究将测试一个定制的，基于社会学习的简短的动机干预与个性化的反馈相比，像往常一样减少物质使用住院的青少年共病物质使用和精神疾病的治疗的比较疗效。我们还将测试治疗对中间变量的影响，如物质使用问题，精神症状，改变的动机和住院后治疗的参与，并将研究改变的机制。 该研究是一项随机（按队列）、两组设计，随着时间的推移进行重复测量，比较以下两种方法的疗效：（a）定制的、简短的动机访谈干预与个性化反馈（MI）vs.（B）常规治疗（TAU）。将招募250名年龄在13至17岁之间的青少年精神病住院患者参加研究。受试者将符合一种或多种DSM-IV（非尼古丁）物质使用障碍和一种或多种除物质使用障碍外的其他当前轴I障碍的标准。将对受试者进行12个月的随访，并使用呼吸分析和唾液药物测试验证自我报告的物质使用戒断。 我们预计这项研究将为相当大比例患有药物使用和精神疾病的青少年开发出一种专门、有效的干预方法，因此将具有重要的临床和公共卫生意义。

DESCRIPTION (provided by applicant): Adolescents with substance use disorders frequently suffer from concomitant psychiatric disorders. Unfortunately, substance use problems among adolescents presenting for psychiatric treatment are often not adequately assessed or addressed despite the deleterious consequences of this comorbid psychopathology. The overall objective of this research program is to develop effective brief intervention approaches to address substance use problems in high-risk adolescents with comorbid psychiatric disorders, and to advance our knowledge of the relationship between psychiatric and substance use disorders within the context of a treatment outcome study. The proposed study will test the comparative efficacy of a tailored, social learning-based brief motivational intervention with personalized feedback compared to treatment as usual for reducing substance use in adolescents hospitalized with comorbid substance use and psychiatric disorders. We will also test the effects of treatment on intermediate variables such as substance use problems, psychiatric symptoms, motivation to change and post-hospitalization treatment involvement, and will examine the mechanisms of change. The study is a randomized (by cohort), two group design with repeated measures over time, comparing the efficacy of: (a) a tailored, brief motivational interviewing intervention with personalized feedback (MI) vs. (b) treatment as usual (TAU). A sample of 250 adolescent psychiatric inpatients between the ages of 13 and 17 will be recruited into the study. Subjects will meet criteria for one of more DSM-IV (non-nicotine) substance use disorders and for one or more additional current Axis I disorders, other than a substance use disorder. Subjects will be followed for 12 months, and self-reported abstinence from substance use will be verified using breath analysis and saliva drug tests. We expect that this study will result in the development of a specialized, efficacious intervention approach for the significant percentage of adolescents with comorbid substance use and psychiatric disorders, and will therefore have important clinical and public health implications.