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Co-Occurring Disorders


Co-existing conditions which is also referred to as dual diagnosis or dual condition pertains to the existence of more than one medical condition at the same time. For example, an individual may suffer from bipolar disorder as well as substance abuse.

Just as the field of treatment for substance abuse and mental disorders has developed to become more accurate, so too has the terminology used to narrate people with both substance use and mental disorders.


The terms dual disorder or dual diagnosis are replaced by the term co-occurring disorders. Even though these replaced terms have usually been used when discussing a mix of mental disorders and substance abuse, they are also referring to other combinations of disorders (like mental disorders and mental retardation), which can sometimes cause confusion.

Besides, these terms imply that only two disorders occur at the very same time when in reality there can be more than two disorders. People who suffer from co-occurring disorders (COD) have one or more disorders that have to do with mental disorders and one or more disorders that have to do with the use of drugs and/or alcohol. When a minimum of one disorder of both types can be confirmed which isn't dependent on the other, we can talk about diagnosing co-occurring disorders and it isn't just a bunch of symptoms that are caused by just one disorder.

Even though the term co-occurring disorder is the most up to date term that is used by professionals, the term dual disorders will be used interchangeably for the objectives of this article.


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For people that suffer from COD, another term is commonly used and it is MICA, which means Mentally Ill Chemical Abusers in cases where patients suffer from an extreme and constant mental disorder like bipolar disorder or schizophrenia. Mentally ill chemically affected people is the phrase that is preferred because the word affected is not pejorative and it designates their condition in a better way. The other acronyms used are as follows: MIC'D (mentally ill chemically dependent), MISA (mentally ill substance abusers), SAMI (substance abuse and mental illness), MISU (mentally ill substance using), ICON PSD (individuals with co-occurring psychiatric and substance disorders) and CAMI (chemical abuse and mental illness).

Common examples of co-occurring disorders include the combinations of alcohol addiction with panic disorder, major depression with cocaine addiction, borderline personality disorder with episodic polydrug abuse, and alcoholism and polydrug addiction with schizophrenia. Even if the emphasis for this dwells on dual disorders, there are a number of patients who have more than two conditions. The fundamentals that have to do with dual disorders normally also have a bearing on multiple disorders.

Combinations of mental disorders and co-occurring problems differ across crucial aspects like seriousness, level of impairment in functioning, duration and disability. For instance, one disorder can be more extreme than the other, or both can be equally mild or extreme. How severe the disorders are also varies with time and is not constant. Degrees of impairment in functioning as well as disability can also change.

That means that, in fact, there are many differentiations among co-occurring disorders, not just one combination. Although patients with the same combination of dual disorders most of the time are met in some treatment programmes.


Over half of adult individuals having serious mental illness also have drug use disorders which can come in the form of misuse or dependency associated with the use of alcohol and drugs.


The differences between patients with a mental health disorder or only a co-occurring disorder problem and patients with dual disorders are that the latter frequently suffer more serious and long-lasting medical, emotional and social challenges. As they suffer from two disorders, they're at risk of a co-occurring disorder relapse and their mental disorder could also worsen. Also, impairment of mental issues many times lead to dependency relapse and addiction relapse commonly leads to further mental deterioration. Therefore, the treatment of relapses should be specifically designed for those with dual disorders. Users with dual disorders commonly need longer rehab, have a greater number of crises and advance more slowly in treatment compared to patients that only have a single disorder.

Psychiatric disorders most prevalent among dually diagnosed patients include personality disorders, mood disorders, psychotic disorders, and anxiety disorders.