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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.

The special terms used to describe people with dual disorder has evolved in the same way that the area of addictions and mental disorder treatment has grown and advanced.


Terms dual diagnosis and dual disorder have thus been replaced with the term co-occurring disorders. These latter terms, though used commonly to point to the mixture of substance abuse and mental disorders, are confusing in that they also point to other mixtures of disorders (like mental retardation and mental disorders).

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 have co-occurring disorders also referred to as COD, often have at least one mental disorder and at least one disorder springing from alcohol or substance abuse as well. In order to get a co-occurring diagnosis, at least one disorder of each type has to be established and traced to be independent and not just a combination of symptoms springing from one disorder but manifesting as independent.

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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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. A preferred definition is mentally ill chemically affected people since their condition is better described by the word affected and is not derogatory. 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).

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 go by the same rules that apply to dual disorders.

The existence of combined co-existing conditions and those of psychiatric disorders can differ in several significant aspects like chronicity, gravity, disability and level of impairment in bodily operations. 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, there isn't a specific combination of dual disorders; in reality, there's a big difference among these. 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).


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. The severity of their condition makes them more prone to COD relapses as well as to worsening of their mental health disorders. What's more, an addiction relapse frequently results in psychiatric decompensation and when mental problems worsen it frequently results in addiction relapse. Therefore, preventing a relapse must be consciously devised for those who suffer from dual disorders. 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.

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