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Co-Existing Conditions


Disorders that occur at the same time are referred to as co-occurring, dual diagnosis or dual disorder. For instance, a person may not only suffer from bipolar disorder but from substance abuse 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.


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. Co-occurring disorders can be diagnosed when a minimum of one disorder of each kind can be verified separate from the other disorder and it's not just a group of symptoms that stem from one of the disorders.

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. The most ideal term used is mentally ill chemically affected individuals because the term affected more aptly describes their condition 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).

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. Some patients have more than two disorders even if the focus of this is on dual disorders. The concept that applies to dual disorders normally applies also to 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. Truly, the seriousness of both disorders can be modified eventually. Degrees of impairment in functioning as well as disability can also change.

That means that, in fact, there are many differentiations among co-occurring disorders, not just one combination. This is not to rule out the fact that one can come across patients who have the same combination of disorders in the course of treatment.


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 susceptible, since they have two disorders, to both further impairment of mental disorder and COD relapse. 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. 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.

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.