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. Someone might have a problem with substance abuse along with bipolar disorder, for instance.

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.


The term co-occurring actually takes the place of the terms dual disorder and dual diagnosis. Even though these replaced terms have usually been used when discussing a mix of mental disorders and substance abuse, they are also referring to other combinations of disorders (like mental disorders and mental retardation), which can sometimes cause confusion.

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. Patients with co-occurring disorders (COD) have one or more mental disorders, as well as one or more disorders that are related to the substance abuse. 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.

Even if co-existing condition is the latest term being used in the medical field, for this specific article, we will use the term dual disorder reciprocally.


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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. 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).

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. Whilst the theme of this relates to dual disorders, a few patients suffer from three or even more disorders. Multiple disorders go by the same rules that apply to dual disorders.

The mixture of psychiatric disorders and COD problems differ along important dimensions like chronicity, disability, severity, and degree of impairment in functioning. For instance, each of the two disorders may be serious or mild, or one may be more serious than the other. Truly, the seriousness of both disorders can be modified eventually. Degrees of impairment in functioning and disability might also differ.

Therefore, no single combination of dual disorders exists and there's indeed significant lack of consistency amongst these disorders. However, certain treatment settings are often encountered for patients with similar mixtures of dual disorders.


More than half of all adults with serious mental illness are further caused by substance use disorders (abuse or addiction related to alcohol or other 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. 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. Therefore, preventing a relapse must be consciously devised for those who suffer from dual disorders. Users with dual disorders commonly need longer rehab, have a greater number of crises and advance more slowly in treatment compared to patients that only have a single disorder.

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