Purpose of Review Substance use disorders (SUD) affect differentially women and men. Although the prevalence has been reported higher in men, those women with addictive disorders present a more vulnerable profile and are less likely to enter treatment than men. The aim of this paper is to present an overview of how sex and gender may influence epidemiology, clinical manifestations, social impact, and the neurobiological basis of these differences of women with SUD, based on human research. Recent Findings The differences in prevalence rates between genders are getting narrower; also, women tend to increase the amount of consumption more rapidly than men, showing an accelerated onset of the SUD (telescoping effect). In respect to clinical features, the most important differences are related to the risk of experience psychiatric comorbidity, the exposure to intimate partner violence, and the associated high risks in sexual and reproductive health; and those who are mothers and addicted to substances are at risk of losing the custody of children accumulating more adverse life events. Some of these differences can be based on neurobiological differences: pharmacokinetic response to substances, sensitivity to gonadal hormones, differences in neurobiological systems as glutamate, endocannabinoids, and genetic differences. Summary Specific research in women who use drugs is very scarce and treatments are not gender-sensitive oriented. For these reasons, it is important to guarantee access to the appropriate treatment of women who use drugs and a need for a gender perspective in the treatment and research of substance use disorders.

Introducción: El consumo de psicoestimulantes como la cocaina y los derivados anfetamínicos se asocia frecuentemente a comorbilidad psiquiátrica. A pesar de que la cocaína y los derivados anfetamínicos comparten muchos efectos agudos y crónicos, existen algunas diferencias importantes entre el tipo de consumidor y las consecuencias de su consumo. Objetivos: Estudiar de forma prospectiva las características diferenciales entre los pacientes ingresados en una unidad de patología dual con consumo de cocaína y de derivados anfetamínicos. Material y métodos: Durante 3 años recopilamos datos demográficos, sociofamiliares y clínicos de aquellos pacientes ingresados en la unidad de patología dual del Parc de Salut Mar que cumplían criterios de trastorno por consumo de psicoestimulantes. Estos pacientes fueron divididos en dos categorías: trastorno por consumo de derivados anfetamínicos o trastorno por consumo de cocaína según los criterios del DSM-IV. Resultados: Se incluyeron 498 pacientes (70,9% hombres; edad media 36,8 ± 7,8 años). La razón principal del ingreso fueron las alucinaciones y/o delirios (36,5%), seguidos de los trastornos de conducta (25,3%). El diagnóstico psiquiátrico más frecuente fue el trastorno psicótico (41,8%). Los sujetos del grupo de anfetaminas eran con más frecuencia varones solteros, con un nivel educativo más elevado y con una mayor prevalencia de antecedentes familiares de enfermedad mental. Requirieron de ingresos de mayor duración y presentaron mayor prevalencia de trastornos por consumo de cannabis y de policonsumo de sustancias psicoactivas así como una menor gravedad clínica en el momento del ingreso. Cabe destacar que los sujetos del grupo de anfetaminas tuvieron un inicio más precoz del consumo de cocaína, cannabis y alcohol. Conclusiones: Nuestros datos muestran que los consumidores de anfetaminas presentan un mayor policonsumo de sustancias y un inicio más precoz del consumo de otras sustancias aunque al inicio del ingreso presentan una menor gravedad clínica.

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a) Objectives: This study analyses the characteristics and prevalence of psychotic disorders in patients with substance use, that needed medical and psychiatric care in a Dual Pathology Department during a 3 years period. b) Background and aims: The strong comorbidity between substance use and psychotic disorders has been deeply studied in recent literature. The aim of this study is to analyse the characteristics of the psychotic episode (primary or drug-induced), the predominant substance of use and the age of onset of consumption, as well as some sociodemographic characteristics in these patients. c) Materials and methods After a bibliographic review of recent literature, we realize a descriptive study of psychotic disorders and substance use from a total of 531 hospitalized patients during a 3 years period, using SPSS for Windows 20.0 database for statistic results. d) Results: In this study we can observe a predominant percentage of males with an average age of 36 years old, around 50% psychotic disorders out of total number of patients with a predominant type of primary psychosis and a high prevalence of cocaine (18% of total patients), alcohol (16%) and cannabis (8%) use and also an early age of onset of problematic consumption (15 years old for alcohol, 16 years old for cannabis and 21 years old for cocaine). e) Conclusions: The result of this study approach the current literature data about psychotic disorders and substance use and underlines the importance of a correct and early diagnosis in patients with a serious mental illness.

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