BackgroundThe use of reliable and valid self-report questionnaires to identify drug use disorders (DUD) is a strategy that has shown usefulness for screening. One of the instruments more used for detection is the Drug Abuse Screening Test (DAST). The psychometric properties in the 20-and 10-item versions have been evaluated in other countries but in Mexico the psychometric and diagnostic properties of both versions are yet to be evaluated.

SUMMARYSubstance use disorders have a high degree of comorbidity with other psychiatric disorders; it has been reported that the prevalence of comorbidity is higher in psychiatric (20-50%) and addiction (50-75%) treatment settings than in household or student populations. Because of limited treatment alternatives and greater treatment needs, MutualAid groups have become relevant in the last decades. A modality of Mutual-Aid for addiction treatment that has proliferated in Mexico has taken the form of residential Mutual-Aid centers called "anexos" in Spanish. The objective of this study was to estimate the prevalence of lifetime comorbidity between substance use disorders and psychiatric disorders in those who attended these residential Mutual-Aid centers. The initial sample consisted of 535 male participants diagnosed with a substance use disorder, but only 346 fulfilled the inclusion criteria to continue with the evaluation. Only males were included as the participating centers only admit males. Psychiatric diagnosis was evaluated with the Composite International Diagnostic Interview (WMH-CIDI) using DSM-IV criteria. The results showed that 75.72% met criteria for any comorbid psychiatric disorder, the most frequent being attention deficit and conduct disorders, followed by anxiety disorders, separation anxiety disorders, mood disorders, impulse control disorders and least frequently eating disorders. While the study is limited by its nonrepresentative sample, the findings provide valuable information for a hidden population for which there is a dearth of information and points to the need for integrative services which address both addiction and comorbid psychiatric disorders simultaneously.Key words: Addiction, treatment settings, comorbidity, psychiatric disorders. RESUMENLa comorbilidad de los trastornos por consumo de sustancias con otros trastornos mentales presenta una importante prevalencia; se ha reportado que ésta es mayor en los centros de tratamiento psiquiátrico (20-50%) y para las adicciones (50-75%) en comparación con la población abierta. Una modalidad de Ayuda-Mutua para la atención de las adicciones común en México es la de los Centros Residenciales y Casas de Recuperación para las adicciones, también llamados "anexos". El objetivo del estudio fue estimar la prevalencia de comorbilidad de los trastornos por consumo de sustancias con otros trastornos psiquiá-tricos en una muestra de participantes de sexo masculino adscritos a los Centros Residenciales de Ayuda-Mutua para la Atención de las Adicciones (CRAMAA). Se captó a un total de 535 participantes, de los cuales 346 cumplieron los criterios de inclusión y fueron evaluados. La evaluación diagnóstica de los trastornos por uso de sustancias y los 17 trastornos psiquiátricos comórbidos se realizó con la Entrevista Internacional Diagnóstica Compuesta (WMH-CIDI). Los resultados mostraron que 75.72% cumplía con criterios diagnósticos para algún trastorno psiquiátrico comórbido, siendo los más prevalentes los trastornos por déficit de atención y com...

Fundamental elements of hegemonic masculinity such as power and violence are analyzed through characteristics of 12-step programs and philosophy immersed in Mutual-Aid Residential Centers for Addiction Treatment (CRAMAAs). CRAMAAs are a culturally specific form of substance abuse treatment in Mexico that are characterized by control and violence. Fifteen interviews were carried out with men of varied sociodemographic characteristics, and who resided in at least two of these centers. Results identify that power is expressed through drug abuse and leads them to subsequent biopsychosocial degradation. Residency in CRAMAAs is motivated by women, but men do not seek the residency and are usually admitted unwillingly. Power through violence is carried out inside CRAMAAs where men are victims of abuse. From a 12-step philosophy, this violence is believed to lead them to a path of recovery but instead produces feelings of anger and frustration. The implications of these centers on Mexican public health are discussed.

Several behaviors, including compulsive gambling, have been considered non-substance-related addictive disorders. Categorical mental disorders (e.g., DSM-5) are usually accompanied by very different symptomatic expressions (affective, behavioral, cognitive, substance abuse, personality traits). When these mental disorders occur with addictive disorders, either concomitantly or sequentially over the life span, this clinical condition is called a dual disorder. Gambling disorder (GD) has been associated with other categorical psychiatric diagnoses: attention deficit hyperactivity disorder, depression, bipolar disorder, social anxiety, schizophrenia, substance use disorder, antisocial personality disorder; and dimensional symptoms including higher impulsivity, poorer emotional wellbeing, cognitive distortion, psychosis, deficient self-regulation, suicide, poorer family environment, and greater mental distress. We are calling this clinical condition Gambling Dual Disorder. From a clinical perspective, it is clear that Gambling Dual Disorder is not the exception but rather the expectation, and this holds true not just for GD, but also for other mental disorders including other addictions. Mental disorders are viewed as biological disorders that involve brain circuits that implicate specific domains of cognition, emotion, and behavior. This narrative review presents the state of the art with respect to GD in order to address current matters from a dual disorder, precision psychiatry, and clinical neuroscience perspective, rather than the more subjective approach of symptomatology and clinical presentation. This review also presents Gambling Dual Disorder as a brain and neurodevelopmental disorder, including from the perspectives of evolutionary psychiatry, genetics, impulsivity as an endophenotype, the self-medication hypothesis, and sexual biological differences. The wide vision of the disease advances a paradigm shift, highlighting how GD and dual disorders should be conceptualized, diagnosed, and treated. Rethinking GD as part of a dual disorder is crucial for its appropriate conceptualization from the perspective of clinical neuroscience and precision psychiatry.

SUMMARYAddictive disorders and behaviors have increased in the past years in Mexico. These behaviors and disorders are considered a public health issue because of the social and economic strains they generate. However, the state is unprepared to attend such high demands. Non government organizations have arisen in order to fulfill this demand, but it is known that many of them do not regard federal health regulations and often they have infringed the basic human rights. The present study has for objective to analyze the experience of men who have been atended in self-help residential substance abuse attention centers. Fifteen focalized interviews were carried out with men of different characteristics, all of them having been attended in at least two centers. The results help to understand the consumption dynamic, usually linked to family abandonment and anger. It further analyzes the unhealthy and inhuman services offered in many of these centers such as poor feeding and hygiene services; many of the men are admitted violently and against their will. It is concluded that even though these centers respond to the demand that addictive disorders have, they do not professionally and skillfully support a rehabilitation process. It is thus of utter importance to guarantee the training and proffessionalization of these centers' staff through an observation and regulation process.Key words: Addictions, treatment, self-help, men. RESUMENLos trastornos y conductas adictivas se han incrementado en México en los últimos años. Estas conductas y trastornos son considerados un problema de salud pública debido a los estragos sociales y económicos que implican. Sin embargo, la demanda de atención ha rebasado las capacidades del Estado, por lo que han surgido organizaciones civiles que buscan responder a dicha problemática, aunque en muchas ocasiones esto suele hacerse sin atender a la reglamentación federal para la atención de la salud y las adicciones, por lo que existen casos en los que se han violentado los derechos humanos básicos. El presente estudio tuvo por objetivo analizar la experiencia de hombres atendidos en centros residenciales de ayuda mutua para la atención de las adicciones. Se llevaron a cabo 15 entrevistas focalizadas con hombres de diferentes características, que habían sido internados en al menos dos de estos centros. Los resultados ayudan a comprender la dinámica de consumo, que usualmente está ligada al abandono familiar y al enojo. Además, se analiza el uso de servicios de estos centros, como alimentación e higiene. Se encontró que muchos de estos hombres fueron ingresados de manera involuntaria y se vieron expuestos a diversas formas de abuso. Se concluye que a pesar de que estos centros responden a una necesidad de la sociedad para atender los problemas de salud que generan las adicciones, es imprescindible garantizar el respeto a los derechos humanos, asegurando la regulación y reglamentación de los centros. INTRODUCCIÓNEl consumo de sustancias psicoactivas afecta de modo significativo la calidad de v...