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Co-Occurring Disorders


Co-Occurring disorders are present when there are two or more disorders at the same moment and these disorders were also called dual diagnosis or dual disorder. For instance, an individual can go through substance dependency while having bipolar disorder, too.

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.


Dual disorder and dual diagnosis terms are replaced by 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.

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. 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.

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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Mentally Ill Chemical Abusers, MICA, is used to refer to people who have a co-occurring disorder and a very serious mental disorder such as bipolar disorder or schizophrenia. A better word that is more preferred in terms of its connotation is Mentally Ill Chemically Affected. 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).

Some typical examples of co-occurring disorders are the combinations of cocaine addiction with major depression, occasional polydrug abuse with borderline personality disorder, panic disorder with alcohol addiction and polydrug addiction and alcoholism with schizophrenia. Whilst the theme of this relates to dual disorders, a few patients suffer from three or even more disorders. Multiple disorders go by the same rules that apply to 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, each of the two disorders may be serious or mild, or one may be more serious than the other. Indeed, the seriousness of both disorders may alter over time. Degree of disability and weakening of bodily functions can as well differ.

Therefore, there isn't a specific combination of dual disorders; in reality, there's a big difference among these. Specific treatment environments are, however, set up for patients that have alike combinations of dual disorders.


More than 50 per cent of adults who suffer from a serious mental disorder are also weakened by substance use disorders (addiction or abuse connected to alcohol or other substances).


The differences between patients with a mental health disorder or only a co-occurring disorder problem and patients with dual disorders are that the latter frequently suffer more serious and long-lasting medical, emotional and social challenges. 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. That means that patients with co-occurring disorders require a specific relapse prevention plan. Unlike patients who only have one disorder, those with dual disorders would mostly need prolonged treatment, have more difficulties and have slow progress in treatment.

Personality, psychotic and mood disorders are among some of the most prevalent psychiatric disorders diagnosed in dual patient disorders.