Disorders that occur at the same time are referred to as co-occurring, dual diagnosis or dual disorder. For example, an individual may suffer from bipolar disorder as well as substance abuse.
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 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 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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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. The most ideal term used is mentally ill chemically affected individuals because the term affected more aptly describes their condition and is not derogatory. 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).
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 even if the focus of this is on dual disorders. Multiple disorders are usually based on the same principles that can be used when talking about 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. Indeed, the seriousness of both disorders may alter over time. Degrees of impairment in functioning and disability might also differ.
Thus, there is no single mixture of dual disorders; in fact, there is huge variability among them. Specific treatment environments are, however, set up for patients that have alike combinations of dual disorders.
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.
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. They are vulnerable to both COD relapse and a worsening of the psychiatric disorder because they have two disorders. Additionally, dependency relapse most of the time causes psychiatric functional deterioration and worsening of psychiatric difficulties which further results in dependency relapse. This is why relapse prevention should be particularly made for patients having 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.