Co-Occurring Disorders during-rehab


Co-occurring disorders (previously called dual disorder or dual diagnosis) describe the existence of two or more than two disorders at the very same point in time. For instance, an individual can go through substance dependency while having bipolar disorder, too.

Just like the area of treatment for drug use and psychological disorders has developed to become more exact, the terminology that is employed to describe people who suffer both from psychological disorders and drug use has also become more precise.


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

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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The acronym MICA (short for Mentally Ill Chemical Abusers) is sometimes used to label people with a co-occurring disorder and a noticeably serious and chronic 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 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 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. Even if the emphasis for this dwells on dual disorders, there are a number of patients who have more than two conditions. 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, one disorder can be more extreme than the other, or both can be equally mild or extreme. Truly, the seriousness of both disorders can be modified eventually. 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. Although patients with the same combination of dual disorders most of the time are met in some treatment programmes.


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).


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. 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. This is why relapse prevention should be particularly made for patients having dual disorders. Users with dual disorders commonly need longer rehab, have a greater number of crises and advance more slowly in treatment compared to patients that only have a single disorder.

Psychiatric disorders most prevalent among dually diagnosed patients include personality disorders, mood disorders, psychotic disorders, and anxiety disorders.