Disorders that occur at the same time during-rehab


Disorders that occur at the same time are referred to as co-occurring, dual diagnosis or dual disorder. For instance, an individual can go through substance dependency while having bipolar disorder, too.

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.


The terms dual disorder or dual diagnosis are replaced by 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.

Also, there can be more than just two disorders present, while these terms are implying otherwise. One or more disorders in the clients with co-occurring disorders (COD) relate to the use of alcohol and/or other drugs of abuse as well as one or more mental disorders. 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. Mentally ill chemically affected people is the phrase that is preferred because the word affected is not pejorative and it designates their condition in a better way. The other acronyms used are as follows MIC'D (mentally ill chemically dependent), MISA (mentally ill substance abusers), SAMI (substance abuse and mental illness), MISU (mentally ill substance using), ICON PSD (individuals with co-occurring psychiatric and substance disorders) and CAMI (chemical abuse and mental illness).

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. Even if the emphasis for this dwells on dual disorders, there are a number of patients who have more than two conditions. Multiple disorders go by the same rules that apply to dual disorders.

Extremity, chronicity, disability and the level of impairment in functioning are some differing extents in which combinations of COD issues and mental disorders vary. For instance, one disorder can be more extreme than the other, or both can be equally mild or extreme. How severe the disorders are also varies with time and is not constant. Degrees of impairment in functioning as well as disability can also change.

Therefore, no single combination of dual disorders exists and there's indeed significant lack of consistency amongst these disorders. Specific treatment environments are, however, set up for patients that have alike combinations of dual disorders.


Further impairment to adults who face severe mental disorders as a result of substance abuse or dependence such as alcohol or other drugs is common.


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. Also, impairment of mental issues many times lead to dependency relapse and addiction relapse commonly leads to further mental deterioration. Therefore, preventing a relapse must be consciously devised for those who suffer from dual disorders. 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 most prevalent among dually diagnosed patients include personality disorders, mood disorders, psychotic disorders, and anxiety disorders.