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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 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. The said terms although usually used to refer to both drug and mental disorders as accompanying conditions, it can be easily misconstrued since they may also mean the combination of other health conditions like mental ailment or mental delay.

Besides, these terms imply that only two disorders occur at the very same time when in reality there can be more than two disorders. Patients who have coexisting conditions can have one or more conditions associated with alcohol or drug dependency and also one or more mental condition. 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.

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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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. The definition of Mentally Ill Chemically Affected people is liked better as "affected" describes their state better and it isn't 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 people might have more than two disorders, even though the cornerstone of this is on dual disorders. The set of ideas which is relevant to dual disorders is as well used for 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.

Thus, there is no single mixture of dual disorders; in fact, there is huge variability among them. Specific treatment environments are, however, set up for patients that have alike combinations of dual disorders.


Further damage is inflicted in more than 50 % of all adults that have severe mental disorder as well as substance abuse disorders (abuse or addiction to alcohol or illicit 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. 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. 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.

Mental disorders that are most common amongst dually diagnosed people are personality disorders, mood disorders, psychotic disorders and mood disorders.