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Disorders that occur at the same time


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.


The terms dual disorder or dual diagnosis are replaced by the term co-occurring disorders. The terms being replaced may be misleading as they also refer to mental disorders and mental retardation occurring together in addition to their popular reference to a combination of substance abuse 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. An identification of co-existing condition is made when there is an existence of at least one disorder of each type which is also separate from the other, not just a series of indications stemming from a particular disorder.

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 most ideal term used is mentally ill chemically affected individuals because the term affected more aptly describes their condition and is not 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 mixture of psychiatric disorders and COD problems differ along important dimensions like chronicity, disability, severity, and degree of impairment in functioning. 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. Degree of disability and weakening of bodily functions can as well differ.

Therefore, it is important to note that there is no single combination of co-occurring disorders; they actually vary depending on the mentioned factors. Although patients with the same combination of dual disorders most of the time are met in some treatment programmes.


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.


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. They are vulnerable to both COD relapse and a worsening of the psychiatric disorder because they have two disorders. Additionally, dependency relapse most of the time causes psychiatric functional deterioration and worsening of psychiatric difficulties which further results in dependency relapse. That means that patients with co-occurring disorders require a specific relapse prevention plan. Unlike patients who only have one disorder, those with dual disorders would mostly need prolonged treatment, have more difficulties and have slow progress in treatment.

Psychiatric disorders which is rampant among patients having dual disorders and can comprise of anxiety disorders, mood disorders, psychotic disorders and personality disorders.