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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, a person may not only suffer from bipolar disorder but from substance abuse too.

The special terms used to describe people with dual disorder has evolved in the same way that the area of addictions and mental disorder treatment has grown and advanced.


The two terms dual diagnosis and dual disorder are replaced by 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.

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. 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.

In this article, the term dual disorders will also be used, even though the term co-occurring disorders is currently utilized among professionals.


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Mentally Ill Chemical Abusers in which the acronym MICA is derived from is sometimes used to describe individuals who have co-existing conditions and an evidently serious and stubborn mental condition like bipolar disorder and 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. Some of the other acronyms are: CAMI (chemical abuse and mental illness), MISU (mentally ill substance using), MISA (mentally ill substance abusers), SAMI (substance 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. The fundamentals that have to do with dual disorders normally also have a bearing on 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, each of the two disorders may be serious or mild, or one may be more serious than the other. However, with time, the extremity of both disorders might change. Other factors that may also vary include the level or degree of disability or impairment in day to day functions.

Therefore, it is important to note that there is no single combination of co-occurring disorders; they actually vary depending on the mentioned factors. 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).


Patients with dual disorders go through much more emotional, social and chronic medical problems in comparison to patients who only have a mental health disorder or a co-occurring disorder caused by substance abuse or dependence only. As they suffer from two disorders, they're at risk of a co-occurring disorder relapse and their mental disorder could also worsen. Further, worsening of psychiatric problems often leads to addiction relapse and addiction relapse often leads to psychiatric decompensation. Thus, for patients with dual disorders relapse prevention must be specially designed. 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.