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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 instance, a person may not only suffer from bipolar disorder but from substance abuse too.

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.


Dual disorder and dual diagnosis terms are replaced by the term co-occurring disorders. Even though the terms dual diagnosis and dual disorder are used regularly to refer to the combination of psychological disorders and drug use, these terms are misleading as they can also refer to other combinations of disorders like mental retardation and psychological disorders.

Also, there can be more than just two disorders present, while these terms are implying otherwise. One or more disorders in the clients with co-occurring disorders (COD) relate to the use of alcohol and/or other drugs of abuse as well as one or more mental disorders. An identification of co-existing condition is made when there is an existence of at least one disorder of each type which is also separate from the other, not just a series of indications stemming from a particular disorder.

Dual disorder is used interchangeably in this article to refer to co-occurring disorders although the latter is the most recent development in the lingo as used in the medical field.


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The acronym MICA (short for Mentally Ill Chemical Abusers) is sometimes used to label people with a co-occurring disorder and a noticeably serious and chronic 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. Other acronyms that are used to refer to people with COD are CAMI, Chemical Abuse and Mental Illness; MIC'D, Mentally Ill Chemically Dependent; MISA, Mentally Ill Substance Abusers; MISU, Mentally Ill Substance Using; Sami, Substance Abuse and Mental Illness and ICO PSD, Individuals with co-occurring psychiatric and substance disorders.

Some typical examples of co-occurring disorders are the combinations of cocaine addiction with major depression, occasional polydrug abuse with borderline personality disorder, panic disorder with alcohol addiction and polydrug addiction and alcoholism with schizophrenia. Some patients have more than two disorders even if the focus of this is on dual disorders. 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, in the event if having two disorders, one may be either serious or mild or that one may be more serious than the other. Truly, the seriousness of both disorders can be modified eventually. Other factors that may also vary include the level or degree of disability or impairment in day to day functions.

Thus, there is no single mixture of dual disorders; in fact, there is huge variability among them. This is not to rule out the fact that one can come across patients who have the same combination of disorders in the course of treatment.


Further damage is inflicted in more than 50 % of all adults that have severe mental disorder as well as substance abuse disorders (abuse or addiction to alcohol or illicit drugs).


Compared patients who have a COD use problem alone or a mental health disorder, and more serious and chronic medical, social and emotional problems are often experienced by the patients with dual disorders. The severity of their condition makes them more prone to COD relapses as well as to worsening of their mental health disorders. Also, a cycle is likely where once there is a relapse in addiction recovery, the patient becomes more prone to a psychiatric worsening which makes it much easier to relapse into an addiction. Thus, for patients with dual disorders relapse prevention must be specially designed. Compared with patients who have a single disorder, patients with dual disorders often have more crises, require longer treatment, and grow more gradually in treatment.

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