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Background Cluster-B personality disorders (DSM-V), particularly borderline and antisocial personality disorders, are associated with high rates of substance use disorder. However, the mechanisms underlying this relationship have yet to be fully understood. Craving has recently been identified as an important component of substance use disorder. The purpose of this article is therefore to review the current literature and explore whether craving could be implicated as an underlying mechanism of comorbid substance use disorder in antisocial and borderline personality disorders.Method Critical review of the literature.Results Emerging evidence indicates that there is in fact an association between craving and personality disorders. Patients afflicted with the latter, incidentally, respond differently to anti-craving medication when compared to normal subjects. While a limited number of studies have directly assessed craving in patients with personality disorders, a growing number have looked at the association between craving and specific personality traits. The correlation between impulsivity, negative affect and craving seems like a plausible explanation for the high prevalence and severity of substance use disorder in subjects with antisocial or borderline personality disorders.Conclusion These findings suggest that specific personality traits are related to craving and could represent promising targets for the prevention, assessment and management of comorbid substance use disorders.

Keywords: troubles liés à l'utilisation d'une substance, craving, trouble de la personnalité, trouble de la personnalité limite, trouble de la personnalité antisociale, impulsivité, affect négatif, Substance use disorders, craving, personality disorders, borderline personality disorder, antisocial personality disorder, impulsivity, negative affect

In this article, the authors discuss the difficulties and opportunities of psychiatric training in an urban setting. Based on the example of Montréal, they ponder the interest and the relevance of this contextual framework for the training of future psychiatrists and other mental health professionals, regardless of the nature and location of their practice after their residency. The authors examine the advantages of this teaching environment and how to overcome its limits.

A strong association exists between impulsivity and addictive behaviors, such as pathological gambling, compulsive eating and substance use disorders, according to a growing number of scientific studies using neurobiological, behavioral and imaging techniques. Substance use disorders are by far the most studied addictive behaviors. This article summarises current empiral data linking impulsivity and substance use disorders, ending with a few treatment guidelines adapted to most clinical setups.

Keywords: Impulsivité, toxicomanie, neurobiologie, traitement, agressivité, Impulsivity, Addiction, Neurobiology, Treatment, Aggressiveness

The article presents the clinical record of an analytic psychodrama group engaged with teenage sexual offenders. From the analysis of the therapists' siderated emotions - both corporal and psychic - and from our conception of the acting out theories, considered here as a psychic deadend, we will consider adolescence as a privileged moment of potential reorganization for thei psyche. Because psychodrama engages mobilization of affects, verbal elaboration, work on corporal engraving and body motion, it also allows for a better reorganization of psychic processes towards representation and symbolization.

Keywords: Adolescents délinquants sexuels, psychodrame, processus psychothérapiques, Teenage sex offenders, psychodrama, psychotherapeutic processes

The article is based on action-research and practical training experience in intercultural relations in Montreal schools. What seemed to emerge was that ignorance of our own cultural resolution is more harmful than ignorance of other cultures, and that the intercultural context provides an opportunity to become aware of these cultural processes and to adjust our performance and methods of action. It enables us to grasp the "content-process-context" dynamics to deal with the complexity of real situations and establish relationships between autonomous systems, whether individuals or institutions.

SummaryComparison of Picasso's painting Les Demoiselles d'Avignon with masks from African societies with the Poro institution. This study shows that the aesthetics of Picasso's painting and the aesthetics of the Poro institution mask are one and the same, whereas the politics of Picasso's work and the politics promoted by the masks are diametrically opposed. Thus the following conclusion: that which is political in art is not located in forms but in the signified.

SummaryThe evaluation of health services is most often defined within the framework of the institution. The experiences of persons desiring access to these services is a potentially rich source of information. With the objective of making it possible for institutions offering ambulatory services in mental health to measure the service they offer to the population, the authors carried out a simulation study of requests for help made by telephone. Professional actors received training to make requests for help to ten institutions in a large city. The information which was collected and analyzed systematically resulted in the definition of service profiles for each institution. The great variability of findings raises the problem of the meaning given to universal accessibility to mental health services in our society. The method of investigation is discussed as to its usefulness in evaluation directed toward the quality of services and of service policies.

SummaryThe object of this paper is to recall how the notions of mental health and social processes are linked from a theoretical point of view. The author first points out how even the way we define mental health and the modes of intervention in relation to it is based inevitably on a conception of society itself and of the relationship between the individual and society. He then reviews a certain number of dimensions of social life (organizational processes, membership systems such as social class, sex, religion, rural-urban milieu, etc.) which mark or determine the relationship between mental health and social processes. The various papers presented in this issue serve as examples of the general framework presented here. The author concludes by situating each of these papers in relation to the field of research in the sociology of mental health.

ABSTRACTThis article re-examines access to treatment and care in the current context of fiscal restriction and change in locus of care. Taking the position that the development of partnerships with all parties who work in the mental health area is an important process, this article argues that such processes are infrequently discussed. Further, creating a partnered relationship with the person with mental disorder is also neglected. The authors examine mechanisms of relationship change as care moved from large, total-care institutions to general hospitals and finally, to the community. How professionnals, individuals with mental disorder and their families have been affected by this change in terms of how alliances are constituted and maintained is discussed. The authors conclude with two case examples which illustrate the reconciliation and non-reconciliation of differing points of view between all partners which likely affected clinical outcomes.