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.
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.
Terms dual diagnosis and dual disorder have thus been replaced with the term co-occurring disorders. 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.
Besides, these terms imply that only two disorders occur at the very same time when in reality there can be more than two disorders. 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. 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.
In this article, the term dual disorders will also be used, even though the term co-occurring disorders is currently utilized among professionals.
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 are: ICOPS (individuals with co-occurring psychiatric and substance disorders), SAMI (substance abuse and mental illness), MIC'D (mentally ill chemically dependent) CAMI (chemical abuse and mental illness), MISU (mentally ill substance using), and MISA (mentally ill substance abusers).
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 are some of the most usual cases of co-occurring disorders. Some patients have more than two disorders even if the focus of this is on dual disorders. The set of ideas which is relevant to dual disorders is as well used for multiple disorders.
Combinations of mental disorders and co-occurring problems differ across crucial aspects like seriousness, level of impairment in functioning, duration and disability. 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. Other factors that may also vary include the level or degree of disability or impairment in day to day functions.
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.
Further damage is inflicted in more than 50 % of all adults that have severe mental disorder as well as substance abuse disorders (abuse or addiction to alcohol or illicit 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. Also, a cycle is likely where once there is a relapse in addiction recovery, the patient becomes more prone to a psychiatric worsening which makes it much easier to relapse into an addiction. Therefore, the treatment of relapses should be specifically designed for those with 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.
Mental disorders that are most common amongst dually diagnosed people are personality disorders, mood disorders, psychotic disorders and mood disorders.