“…In a previous study (Frieri et al, 2014) male gender raised the SUD risk almost threefold, after controlling for psychiatric history and clinical status. The sex difference may be due to higher rates of exposure to heavy alcohol-and drug-use in males than in females and this is particularly true in males with mental disorders (Compton et al, 2000; Kessler et al, 1997) and in psychiatric inpatients (Lambert et al, 1996;Hansen et al, 2000;Mueser et al, 2000;Bonsack et al, 2006;Vaaler et al, 2006). However, in the last decades, gender roles have changed in many societies and some studies suggest that the drinking and substance use patterns of men and women are converging (Seedat et al, 2009).…”