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Co-Occurring Disorders


Co-occurring disorders (previously called dual disorder or dual diagnosis) describe the existence of two or more than two disorders at the very same point in time. For instance, an individual can go through substance dependency while having bipolar disorder, too.

The terminology that is utilized to describe patients with both substance abuse and psychological disorders has developed to be more accurate, just like the field of treatment for both of them.


Terms dual diagnosis and dual disorder have thus been replaced with the term co-occurring disorders. The terms being replaced may be misleading as they also refer to mental disorders and mental retardation occurring together in addition to their popular reference to a combination of substance abuse and mental disorders.

Additionally, the terminology may denote of the occurrence of just two disorders simultaneously when as a matter of fact there could be others, too. 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. 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.

For the purposes of this article, we will use the dual disorders term interchangeably even if the co-occurring disorder is the most current term used professionally.


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Mentally Ill Chemical Abusers, MICA, is used to refer to people who have a co-occurring disorder and a very serious mental disorder such as bipolar disorder or schizophrenia. The definition of Mentally Ill Chemically Affected people is liked better as "affected" describes their state better and it isn't derogatory. 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 common types of co-existing conditions consist of the combinations of major depression types associated with cocaine dependency, alcohol dependency along with panic disorder, extreme alcoholism along with polydrug abuse with schizophrenia and as well as borderline personality condition with sporadic polydrug misuse. Whilst the theme of this relates to dual disorders, a few patients suffer from three or even more disorders. Multiple disorders are usually based on the same principles that can be used when talking about dual disorders.

The severity, degree of impairment in functioning, chronicity and disability are some of the factors that differ in the occurrence of combinations of psychiatric disorders alongside substance abuse problems. For instance, one disorder can be more extreme than the other, or both can be equally mild or extreme. Indeed, the seriousness of both disorders may alter over time. Other factors that may also vary include the level or degree of disability or impairment in day to day functions.

Therefore, it is important to note that there is no single combination of co-occurring disorders; they actually vary depending on the mentioned factors. 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.


More than 50 per cent of adults who suffer from a serious mental disorder are also weakened by substance use disorders (addiction or abuse connected to alcohol or other substances).


Unlike individuals who are diagnosed with mental health disorders or those with alcohol and drug dependency issues alone, those with dual disorders most of the time undergo serious and long lasting medical, emotional and social difficulties. As they suffer from two disorders, they're at risk of a co-occurring disorder relapse and their mental disorder could also worsen. 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. That means that patients with co-occurring disorders require a specific relapse prevention plan. Unlike patients who only have one disorder, those with dual disorders would mostly need prolonged treatment, have more difficulties and have slow progress in treatment.

Mood disorders, personality disorders, psychotic disorders and anxiety disorders are some of the most common mental disorders present among patients that suffer from co-occurring disorders.