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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.

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 two terms dual diagnosis and dual disorder 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.

Furthermore, the terms relate that there are only two disorders occurring at the same time, when truly there may be more. 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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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. Other acronyms include SAMI (Substance abuse and mental illness), MISA (mentally ill substance abusers), MISU (mentally ill substance using), CAMI (chemical abuse and mental illness), ICO PSD (individuals with co-occurring psychiatric and substance disorders) and MIC'D (mentally ill chemically dependent).

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 are some of the most usual cases of co-occurring disorders. Some patients have more than two disorders although the article focuses more 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. As an example, both disorders can be mild or serious or one disorder can be more serious than the other disorder. Indeed, the seriousness of both disorders may alter over time. Degrees of impairment in functioning as well as disability can also change.

Therefore, there isn't a specific combination of dual disorders; in reality, there's a big difference among these. However, certain treatment settings are often encountered for patients with similar mixtures of dual disorders.


Further impairment to adults who face severe mental disorders as a result of substance abuse or dependence such as alcohol or other drugs is common.


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. As they suffer from two disorders, they're at risk of a co-occurring disorder relapse and their mental disorder could also worsen. What's more, an addiction relapse frequently results in psychiatric decompensation and when mental problems worsen it frequently results in addiction relapse. 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.