Co-Occurring Disorders during-rehab


Co-occurring disorders (previously called dual disorder or dual diagnosis) describe the existence of two or more than two disorders at the very same point in time. For instance, a person may not only suffer from bipolar disorder but from substance abuse 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. Even though these replaced terms have usually been used when discussing a mix of mental disorders and substance abuse, they are also referring to other combinations of disorders (like mental disorders and mental retardation), which can sometimes cause confusion.

Furthermore, the terms relate that there are only two disorders occurring at the same time, when truly there may be more. People who suffer from co-occurring disorders (COD) have one or more disorders that have to do with mental disorders and one or more disorders that have to do with the use of drugs and/or alcohol. 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.

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, 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. Mentally ill chemically affected people is the phrase that is preferred because the word affected is not pejorative and it designates their condition in a better way. 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).

Some common types of co-existing conditions consist of the combinations of major depression types associated with cocaine dependency, alcohol dependency along with panic disorder, extreme alcoholism along with polydrug abuse with schizophrenia and as well as borderline personality condition with sporadic polydrug misuse. Even if the emphasis for this dwells on dual disorders, there are a number of patients who have more than two conditions. The concept that applies to dual disorders normally applies also to multiple 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, one disorder can be more extreme than the other, or both can be equally mild or extreme. Indeed, the seriousness of both disorders may alter over time. Levels of impairment and disability in functioning may 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.


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.


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. Additionally, dependency relapse most of the time causes psychiatric functional deterioration and worsening of psychiatric difficulties which further results in dependency relapse. That means that patients with co-occurring disorders require a specific relapse prevention plan. 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.

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