The purpose of this Mentored Patient-Oriented Research Career Development (K23) Award is to study the linkage between substance abuse and the subsequent development of schizophrenia in adolescents and young adults. A key element in understanding this linkage may be the decision-making process: In substance abuse, a dysfunction of the brain reward circuit may result in an impairment in decision-making only when there is an immediate reward expectancy. In schizophrenia, a prefrontal cortical deficit may result in an impairment in decision-making independent of immediate reward expectancy. This award has three specific aims for investigating this assumption: (1) to assess and compare decision-making tasks with and without immediate reward expectancy between cannabis abusers with and without schizophrenia, patients with schizophrenia and no substance abuse, and normal controls; (2) to examine the association between the decision-making process, negative symptoms, and neurocognitive functions of the prefrontal cortex in schizophrenia patients initially and after one year of treatment; (3) to examine the association between decision-making and variables such as gender, conduct and antisocial personality disorders, impulse control disorders, and symptom dimensions. Major career development activities of this award are (1) didactic programs in decision-making and cognitive assessments of the prefrontal cortex; (2) participation in a large ongoing clinical trial comparing patients experiencing their first episode of psychosis, with and without a history of substance abuse, following them for treatment response and neurocognition; (3) the design, conduct and analyses of a study using computerized decision-making tasks with and without immediate reward. Long-term objectives of this award are: (1) to gain expertise in the psychiatric consequences of addiction; (2) to develop research programs at Hillside Hospital aimed at improving the care of dual-diagnosis patients; (3) to introduce the field of decision-making in research and clinical programs at Hillside Hospital. This revised application has been strengthened by (1) focusing the research project on cannabis abuse, which will result in the study of more homogenous groups of patients and increased statistical power; (2) adding training in neuroscience and neuroimaging; and (3) clarifying the study design with additional information pertaining to the first-psychotic episode study.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA015541-05
Application #
7423869
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Kahana, Shoshana Y
Project Start
2004-06-01
Project End
2009-05-31
Budget Start
2008-06-01
Budget End
2009-05-31
Support Year
5
Fiscal Year
2008
Total Cost
$178,241
Indirect Cost
Name
Feinstein Institute for Medical Research
Department
Type
DUNS #
110565913
City
Manhasset
State
NY
Country
United States
Zip Code
11030
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Sevy, Serge; Robinson, Delbert G; Sunday, Suzanne et al. (2011) Olanzapine vs. risperidone in patients with first-episode schizophrenia and a lifetime history of cannabis use disorders: 16-week clinical and substance use outcomes. Psychiatry Res 188:310-4
Gallego, Juan A; Robinson, Delbert G; Sevy, Serge M et al. (2011) Time to treatment response in first-episode schizophrenia: should acute treatment trials last several months? J Clin Psychiatry 72:1691-6
Ashtari, Manzar; Avants, Brian; Cyckowski, Laura et al. (2011) Medial temporal structures and memory functions in adolescents with heavy cannabis use. J Psychiatr Res 45:1055-66
Sevy, Serge; Robinson, Delbert G; Napolitano, Barbara et al. (2010) Are cannabis use disorders associated with an earlier age at onset of psychosis? A study in first episode schizophrenia. Schizophr Res 120:101-7
Lencz, Todd; Robinson, Delbert G; Napolitano, Barbara et al. (2010) DRD2 promoter region variation predicts antipsychotic-induced weight gain in first episode schizophrenia. Pharmacogenet Genomics 20:569-72
Miller, Rachel; Ream, Geoffrey; McCormack, Joanne et al. (2009) A prospective study of cannabis use as a risk factor for non-adherence and treatment dropout in first-episode schizophrenia. Schizophr Res 113:138-44
Ashtari, Manzar; Cervellione, Kelly; Cottone, John et al. (2009) Diffusion abnormalities in adolescents and young adults with a history of heavy cannabis use. J Psychiatr Res 43:189-204
Goldberg, Terry E; Burdick, Katherine E; McCormack, Joanne et al. (2009) Lack of an inverse relationship between duration of untreated psychosis and cognitive function in first episode schizophrenia. Schizophr Res 107:262-6
Sevy, Serge; Smith, Gwenn S; Ma, Yilong et al. (2008) Cerebral glucose metabolism and D2/D3 receptor availability in young adults with cannabis dependence measured with positron emission tomography. Psychopharmacology (Berl) 197:549-56

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