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

描述（由申请人提供）：精神分裂症（SCZ）患者的物质使用障碍（SUD）发生率相对于一般人群升高，最突出的是酒精、尼古丁和大麻。SCZ中同时发生的酒精使用障碍（AUD）与SCZ的症状增加、暴力和受害、无家可归、机构化和总体结局较差相关。尽管AUD（和其他SUD）在SCZ中的患病率和后果，但SCZ患者中合并AUD/SUD的有效治疗方法有限。许多理论模型，包括生物学，认知或心理社会，已被讨论，试图解释这种并发症在SCZ的患病率增加，并指导治疗。然而，很少有人尝试将这些模型整合到SCZ患者酒精和其他SUD基础的统一理论中-这一理论可以随着时间的推移进行测试，并可能导致新的治疗策略的发展。如果要开发更好的治疗方法，就必须建立这些并发疾病的综合理论和实践模型。我们建议召开一次会议，召集一个多学科的科学家和科学家从业者小组，他们的研究基于（或告知）AUD，SCZ的病因和治疗的生物学，认知和/或心理社会模型，以及SCZ中共同发生的AUD/SUD。访问科学家，无论是专家还是初级科学家，都将与达特茅斯的教师一起展示他们的研究和相关文献。由会议主席领导的一系列讨论将寻求整合这些演示文稿，找到领域之间的理论桥梁，并促进可检验假设的发展，以实证评估SCZ中AUD的综合模型。因此，本次会议的具体目标将是：（1）描述在SCZ中同时发生的AUD的患病率和现象学;（2）解释和整合在SCZ中同时发生的AUD/SUD的生物学、认知学和心理社会学病因学理论;（3）描述当前和潜在有效的针对同时发生的AUD和SCZ的药理学、心理学、行为学、社会学和环境干预;（4）提出基于理论模型的新的治疗方法来解释SCZ中AUD/SUD的共同发生。 公共卫生相关性：同时发生的酒精（和其他物质）使用障碍在精神分裂症患者中很常见，并导致这种严重精神疾病患者的预后不良。目前的治疗方法对这些患者的有效性有限。本次会议将聚集该领域的专家，整合与精神分裂症中酒精（和其他物质使用）障碍基础相关的现有理论，并基于这种整合，将开发新的治疗方法，旨在改善这些难以治疗的患者的结果。

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.