CROSS-NATIONAL STUDIES OF DRUG INVOLVEMENT: WMH2000

说明(由申请人提供)：本提案寻求五年的R01奖励，用于对已经收集的药物依赖流行病学数据、导致药物依赖的药物参与阶段和药物依赖的后遗症，包括缓解、康复、治疗和可疑的不良后果(例如，精神障碍，以及对学校、工作和家庭生活中的社会适应的影响)的跨国比较分析提供支持。作为世界精神卫生调查倡议的一部分，目前正在收集即将分析的一般人口流行病学调查数据，目前有28个参与国，其中16个国家拥有具有国家代表性的家庭居民样本，12个国家拥有具有区域代表性的样本。拟议的由NIDA支持的数据分析和科学写作研究小组由吉姆·安东尼教授(约翰·霍普金斯大学)和罗恩·凯斯勒教授(哈佛大学)领导。在01年期间，哈佛团队的主要职责是创建主数据文件和记录责任，包括记录采样框架和程序、采样重量等，霍普金斯团队的重点是为面向NIDA的药物依赖性分析创建构造变量，并汇集有助于描述每个参与国涉及毒品的国家一级背景的信息(例如，关于酒精、烟草、非法药物和处方药或非处方药可获得性的信息；五年分析和科学编写计划将以一套三项业务目标和五项专题目标为指导，加强对药物使用和药物依赖问题的国际比较流行病学的看法，其中每一项目标都与毒品牵涉和药物依赖问题流行病学研究概念模型中的五个主要专题目标相对应。在这项跨国家和比较研究中要回答的主要研究问题是：(1)在被研究的人群中，有多少人受到影响(例如，药物依赖病例)？(2)在这些人群中，最有可能发现受影响的病例是什么？(3)是什么原因导致一些人成为病例，而另一些人没有成为病例？(4)驱动药物依赖的发病和病因及其以精神障碍和社会适应形式出现的后果的因果机制是什么？以及(5)我们可以做些什么来预防和控制药物依赖(例如，通过增加已治疗/未治疗病例的比例，以及通过初级保健外展)？

DESCRIPTION (provided by applicant): This proposal seeks five years of R01 award support for cross-national comparative analyses of already gathered data on drug dependence epidemiology, the stages of drug involvement leading up to drug dependence, and sequelae of drug dependence, including remission, recovery, treatment, and suspected adverse consequences (e.g., psychiatric disturbances, and effects on social adaptation in school, work, and family life). The general population epidemiological survey data to be analyzed now are being gathered as part of the World Mental Health survey initiative, with currently 28 participating countries, including 16 countries with nationally representative samples of household residents and 12 countries with regionally representative samples. The proposed NIDA-supported research team for data analysis and scientific writing is led by Professors Jim Anthony (Johns Hopkins University) and Professor Ron Kessler (Harvard University). Working in coordination, during Year 01, the primary responsibility of the Harvard team is master data file creation and documentation responsibilities, including documentation of sampling frames and procedures, sampling weights, etc., with the Hopkins team focused upon creation of constructed variables for NIDA-oriented drug dependence analyses and assembly of ancillary elements of information that will help describe the country-level context of drug involvement in each of the participating countries (e.g., information about alcohol, tobacco, illegal drug, and medicinal drug availability by prescription or over the counter; availability of local inhalant drugs).The five year analysis and scientific writing plan will provide an enhanced view of the international comparative epidemiology of drug use and drug dependence problems, guided by a set of three operational aims and five subject-matter aims, each of which corresponds with the five main rubics in a conceptual model for epidemiologieal research on drug involvement and drug dependence. The main research questions to be answered in this cross-national and comparative study are: (1) Within the populations under study, how many are affected (e.g., as cases of drug dependence)? (2) Within these populations, where are the affected cases most likely to be found? (3) What accounts for some individuals to become cases while others do not become cases? (4) What are the causal mechanisms that drive the pathogenesis and etiology of drug dependence and its consequences in the form of psychiatric disturbances and social adaptation, and (5) What might we do to prevent and control drug dependence (e.g., by increasing the ratio of treated/untreated cases, and through primary care outreach)?