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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, an individual can go through substance dependency while having bipolar disorder, 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.


Dual disorder and dual diagnosis terms 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.

Even if co-existing condition is the latest term being used in the medical field, for this specific article, we will use the term dual disorder reciprocally.


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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. 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).

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. Multiple disorders are usually based on the same principles that can be used when talking about dual disorders.

Combinations of mental disorders and co-occurring problems differ across crucial aspects like seriousness, level of impairment in functioning, duration and disability. As an example, both disorders can be mild or serious or one disorder can be more serious than the other disorder. How severe the disorders are also varies with time and is not constant. Other factors that may also vary include the level or degree of disability or impairment in day to day functions.

Therefore, no single combination of dual disorders exists and there's indeed significant lack of consistency amongst these disorders. Although patients with the same combination of dual disorders most of the time are met in some treatment programmes.


More than half of all adults with serious mental illness are further caused by substance use disorders (abuse or addiction related to alcohol or other drugs).


Compared patients who have a COD use problem alone or a mental health disorder, and more serious and chronic medical, social and emotional problems are often experienced by the patients with dual disorders. As they suffer from two disorders, they're at risk of a co-occurring disorder relapse and their mental disorder could also worsen. Also, impairment of mental issues many times lead to dependency relapse and addiction relapse commonly leads to further mental deterioration. 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.