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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, an individual can go through substance dependency while having bipolar disorder, too.

Just like the area of treatment for drug use and psychological disorders has developed to become more exact, the terminology that is employed to describe people who suffer both from psychological disorders and drug use has also become more precise.


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. 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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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. A better word that is more preferred in terms of its connotation is Mentally Ill Chemically Affected. 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).

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. Even if the emphasis for this dwells on dual disorders, there are a number of patients who have more than two conditions. 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. In fact the seriousness of both disorders can alter as time passes. Degrees of impairment in functioning and disability might also differ.

That means that, in fact, there are many differentiations among co-occurring disorders, not just one combination. Though, patients with combinations of dual disorders that are alike are regularly found in specific treatment environments.


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).


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. Since they have two disorders, they are at a risk of COD relapse and deterioration of the psychiatric ailment. Also, impairment of mental issues many times lead to dependency relapse and addiction relapse commonly leads to further mental deterioration. This is why relapse prevention should be particularly made for patients having dual disorders. Patients who battle with dual disorders frequently need longer treatment, experience more emergencies and advance more slowly in treatment than patients who battle just a single disorder.

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