Co-Existing Conditions 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, a person may not only suffer from bipolar disorder but from substance abuse too.

The terminology that is utilized to describe patients with both substance abuse and psychological disorders has developed to be more accurate, just like the field of treatment for both of them.


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.

The terms are also misleading in that they only cover two disorders occurring at the same time which is not the case as two or more can occur at the same time. People who suffer from co-occurring disorders (COD) have one or more disorders that have to do with mental disorders and one or more disorders that have to do with the use of drugs and/or alcohol. 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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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. Multiple disorders are usually based on the same principles that can be used when talking about 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. As an example, both disorders can be mild or serious or one disorder can be more serious than the other disorder. Truly, the seriousness of both disorders can be modified eventually. Levels of impairment and disability in functioning may also differ.

Thus, there is no single mixture of dual disorders; in fact, there is huge variability among them. Though, patients with combinations of dual disorders that are alike are regularly found in specific treatment environments.


More than 50 per cent of adults who suffer from a serious mental disorder are also weakened by substance use disorders (addiction or abuse connected to alcohol or other substances).


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. Since they have two disorders, they are at a risk of COD relapse and deterioration of the psychiatric ailment. 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.