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Co-Occurring Disorders


Disorders that occur at the same time are referred to as co-occurring, dual diagnosis or dual disorder. Someone might have a problem with substance abuse along with bipolar disorder, for instance.

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 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. Patients who have coexisting conditions can have one or more conditions associated with alcohol or drug dependency and also one or more mental condition. 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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Mentally Ill Chemical Abusers in which the acronym MICA is derived from is sometimes used to describe individuals who have co-existing conditions and an evidently serious and stubborn mental condition like bipolar disorder and 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 are: ICOPS (individuals with co-occurring psychiatric and substance disorders), SAMI (substance abuse and mental illness), MIC'D (mentally ill chemically dependent) CAMI (chemical abuse and mental illness), MISU (mentally ill substance using), and MISA (mentally ill substance abusers).

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. 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.

The mixture of psychiatric disorders and COD problems differ along important dimensions like chronicity, disability, severity, and degree of impairment in functioning. For instance, each of the two disorders may be serious or mild, or one may be more serious than the other. How severe the disorders are also varies with time and is not constant. 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. 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.


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. Therefore, the treatment of relapses should be specifically designed for those with dual disorders. 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.

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.