Co-Occurring Disorders during-rehab


Disorders that occur at the same time are referred to as co-occurring, dual diagnosis or dual disorder. An example is when someone suffers from drug abuse and bipolar disorder.

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.


Dual disorder and dual diagnosis terms 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.

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. 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.

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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The acronym MICA, which constitutes the phrase Mentally ILL Chemical Abusers, is eventually used to nominate people who have a COD and markedly serious and continued mental disorder like bipolar disorder or schizophrenia. A preferred definition is mentally ill chemically affected people since their condition is better described by the word affected and is not derogatory. Some of the other acronyms are CAMI (chemical abuse and mental illness), MISU (mentally ill substance using), MISA (mentally ill substance abusers), SAMI (substance abuse and mental illness), ICO PSD (individuals with co-occurring psychiatric and substance disorders) and MIC'D (mentally ill chemically dependent).

Borderline personality disorder with periodic polydrug abuse, alcoholism and polydrug addiction alongside schizophrenia, cocaine addiction alongside major depression are some of the most common or popular examples of co-occurring disorders. Whilst the theme of this relates to dual disorders, a few patients suffer from three or even more 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. Indeed, the seriousness of both disorders may alter over time. Degrees of impairment in functioning as well as disability can also change.

That means that, in fact, there are many differentiations among co-occurring disorders, not just one combination. Though, patients with combinations of dual disorders that are alike are regularly found in specific treatment environments.


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. Since they have two disorders, they are at a risk of COD relapse and deterioration of the psychiatric ailment. What's more, an addiction relapse frequently results in psychiatric decompensation and when mental problems worsen it frequently results in addiction relapse. Therefore, preventing a relapse must be consciously devised for those who suffer from dual disorders. Dual disorder patients often need longer periods of treatment, have more crises and progress slowly in treatment in comparison to patients who have a single disorder.

Mood disorders, personality disorders, psychotic disorders and anxiety disorders are some of the most common mental disorders present among patients that suffer from co-occurring disorders.