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Co-Occurring Disorders


Disorders that occur at the same time are referred to as co-occurring, dual diagnosis or dual disorder. An example is when someone suffers from drug abuse and bipolar disorder.

While the scope of treatment for drug dependency and mental conditions has emerged to be rather specific, the same thing goes as well for the terms used to refer to individuals who both have problems with drug dependency and mental conditions.


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.

The terms are also misleading in that they only cover two disorders occurring at the same time which is not the case as two or more can occur at the same time. 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. In order to get a co-occurring diagnosis, at least one disorder of each type has to be established and traced to be independent and not just a combination of symptoms springing from one disorder but manifesting as independent.

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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The acronym MICA, which constitutes the phrase Mentally ILL Chemical Abusers, is eventually used to nominate people who have a COD and markedly serious and continued 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 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).

Common examples of co-occurring disorders include the combinations of alcohol addiction with panic disorder, major depression with cocaine addiction, borderline personality disorder with episodic polydrug abuse, and alcoholism and polydrug addiction with schizophrenia. Some patients have more than two disorders even if the focus of this is on dual disorders. The set of ideas which is relevant to dual disorders is as well used for multiple disorders.

The severity, degree of impairment in functioning, chronicity and disability are some of the factors that differ in the occurrence of combinations of psychiatric disorders alongside substance abuse problems. For instance, each of the two disorders may be serious or mild, or one may be more serious than the other. In fact the seriousness of both disorders can alter as time passes. Other factors that may also vary include the level or degree of disability or impairment in day to day functions.

That means that, in fact, there are many differentiations among co-occurring disorders, not just one combination. Although patients with the same combination of dual disorders most of the time are met in some treatment programmes.


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.


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. 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. 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.

Psychiatric disorders which is rampant among patients having dual disorders and can comprise of anxiety disorders, mood disorders, psychotic disorders and personality disorders.