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Co-Occurring Disorders

Co-existing conditions which is also referred to as dual diagnosis or dual condition pertains to the existence of more than one medical condition at the same time. For instance, a person may not only suffer from bipolar disorder but from substance abuse 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 term co-occurring actually takes the place of the terms dual disorder and dual diagnosis. 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. 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. 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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Mentally Ill Chemical Abusers, MICA, is used to refer to people who have a co-occurring disorder and a very serious mental disorder such as 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. 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).

Common examples of co-occurring disorders include the combinations of alcohol addiction with panic disorder, major depression with cocaine addiction, borderline personality disorder with episodic polydrug abuse, and alcoholism and polydrug addiction with schizophrenia. Some patients have more than two disorders although the article focuses more on dual disorders. The concept that applies to dual disorders normally applies also to multiple disorders.

Combinations of mental disorders and co-occurring problems differ across crucial aspects like seriousness, level of impairment in functioning, duration and disability. As an example, both disorders can be mild or serious or one disorder can be more serious than the other disorder. In fact the seriousness of both disorders can alter as time passes. Degree of disability and weakening of bodily functions can as well differ.

Therefore, no single combination of dual disorders exists and there's indeed significant lack of consistency amongst these disorders. Although patients with the same combination of dual disorders most of the time are met in some treatment programmes.

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).

Patients with dual disorders go through much more emotional, social and chronic medical problems in comparison to patients who only have a mental health disorder or a co-occurring disorder caused by substance abuse or dependence only. The severity of their condition makes them more prone to COD relapses as well as to worsening of their mental health disorders. Further, worsening of psychiatric problems often leads to addiction relapse and addiction relapse often leads to psychiatric decompensation. 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.

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