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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.

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. 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. 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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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. 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.

Borderline personality disorder with periodic polydrug abuse, alcoholism and polydrug addiction alongside schizophrenia, cocaine addiction alongside major depression are some of the most common or popular examples of co-occurring disorders. Some patients have more than two disorders although the article focuses more on dual disorders. Multiple disorders are usually based on the same principles that can be used when talking about dual 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. Degrees of impairment in functioning and disability might also differ.

Therefore, no single combination of dual disorders exists and there's indeed significant lack of consistency amongst these disorders. Although patients with the same combination of dual disorders most of the time are met in some treatment programmes.


More than half of all adults with serious mental illness are further caused by substance use disorders (abuse or addiction related to alcohol or other drugs).


Patients that have co-occurring disorders commonly feel stronger and chronic medical, emotional and social issues compared to those that only have a mental disorder or COD without the other. They are vulnerable to both COD relapse and a worsening of the psychiatric disorder because they have two disorders. What's more, an addiction relapse frequently results in psychiatric decompensation and when mental problems worsen it frequently results in addiction relapse. Thus, for patients with dual disorders relapse prevention must be specially designed. Dual disorder patients often need longer periods of treatment, have more crises and progress slowly in treatment in comparison to patients who have a single disorder.

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.