Co-Occurring Disorders during-rehab


Disorders that occur at the same time are referred to as co-occurring, dual diagnosis or dual disorder. Someone might have a problem with substance abuse along with bipolar disorder, for instance.

Just as the field of treatment for substance abuse and mental disorders has developed to become more accurate, so too has the terminology used to narrate people with both substance use and mental disorders.


Terms dual diagnosis and dual disorder have thus been replaced with 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.

Furthermore, the terms relate that there are only two disorders occurring at the same time, when truly there may be more. One or more disorders in the clients with co-occurring disorders (COD) relate to the use of alcohol and/or other drugs of abuse as well as one or more mental disorders. 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.

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 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. A better word that is more preferred in terms of its connotation is Mentally Ill Chemically Affected. 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).

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. Some patients have more than two disorders even if the focus of this is on dual disorders. Multiple disorders go by the same rules that apply to dual 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. 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.


Further impairment to adults who face severe mental disorders as a result of substance abuse or dependence such as alcohol or other drugs is common.


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. 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. Dual disorder patients often need longer periods of treatment, have more crises and progress slowly in treatment in comparison to patients who have a single disorder.

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