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Disorders that occur at the same time


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 terms dual disorder or dual diagnosis are replaced by the term co-occurring disorders. These latter terms, though used commonly to point to the mixture of substance abuse and mental disorders, are confusing in that they also point to other mixtures of disorders (like mental retardation and mental 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. 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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For people that suffer from COD, another term is commonly used and it is MICA, which means Mentally Ill Chemical Abusers in cases where patients suffer from an extreme and constant mental disorder like 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 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 example, both disorders could be of the same severity or one could be mild while the other is severe. How severe the disorders are also varies with time and is not constant. Degrees of impairment in functioning as well as disability can also change.

Therefore, there isn't a specific combination of dual disorders; in reality, there's a big difference among these. Specific treatment environments are, however, set up for patients that have alike combinations of dual disorders.


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 susceptible, since they have two disorders, to both further impairment of mental disorder and COD relapse. Also, a cycle is likely where once there is a relapse in addiction recovery, the patient becomes more prone to a psychiatric worsening which makes it much easier to relapse into an addiction. 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.

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