NIDA's strategic planning emphasizes the need to increase the real-world relevance of research by prioritizing ?research that incorporates real-world complexities including common comorbidities? that ?interact to affect symptom profiles, illness trajectory, and treatment outcomes?. The overall goal of the current application is to characterize the impact of the common comorbidity between psychosis spectrum disorders (PSD, including schizophrenia, schizoaffective disorder and bipolar disorder) and cocaine use disorders (CUD) on cognition, emotion processing and functional outcomes. Clinical and sociodemographic correlates of comorbid PSD+CUD, and pathways to functional outcomes in comorbid PSD+CUD will also be explored. To do this, three existing datasets will be used, with comprehensive diagnostic, clinical, cognitive and functional data, including patients with comorbid PSD and CUD (PSD+CUD), and 3 comparison groups: patients with PSD without CUD, patients with CUD without PSD, and healthy controls without psychiatric disorder. This unique design, including all 3 relevant control groups, will allow to elucidate the combined effect of comorbid PSD+CUD, compared to the effect of PSD or CUD alone, on cognition and emotion processing, and test two alternate models: an additive model and a self- medication model. The present study will focus on 3 specific aims: 1) To characterize sociodemographic and clinical correlates of comorbid PSD+CUD; 2) To characterize cognitive and emotion processing impairments in comorbid PSD+CUD; 3) To characterize functional impairments in comorbid PSD+CUD, and to identify predictors and pathways to social functioning. ANOVAs and Chi- square tests will be used to compare the groups on sociodemographic features, clinical features, cognitive and emotion processing performance and functional outcomes. Linear and logistic regressions, structural equation modeling and machine learning will be used to identify predictors and model pathways to functional outcomes, taking into account possible mediators. Data from this study will increase our understanding of the impact of comorbid PSD+CUD on cognition, emotion processing and pathways to functional outcomes. We will also characterize the sociodemographic and clinical correlates of comorbid PSD+CUD. This will allow to identify those at risk for comorbid PSD+CUD, and to tailor personalized prevention and intervention approaches, targeting specific factors identified in the models. For example, cognitive and emotion processing impairments are modifiable through cognitive/emotion processing remediation strategies.
The overall goal of the current application is to examine the impact of the common comorbidity of psychosis spectrum disorders (PSD) and cocaine use disorders (CUD) on cognition, emotion processing and social functioning. We will also characterize the clinical and sociodemographic correlates of PSD+CUD and explore predictors and pathways to functional outcomes. Understanding the clinical and sociodemographic correlates of comorbid PSD+CUD, and the factors that underlie functional outcomes, will allow to identify those at risk and tailor personalized prevention and intervention approaches.
