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Disorders that occur at the same time


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.

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. 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. When a minimum of one disorder of both types can be confirmed which isn't dependent on the other, we can talk about diagnosing co-occurring disorders and it isn't just a bunch of symptoms that are caused by just one disorder.

In this article, the term dual disorders will also be used, even though the term co-occurring disorders is currently utilized among professionals.


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Mentally Ill Chemical Abusers in which the acronym MICA is derived from is sometimes used to describe individuals who have co-existing conditions and an evidently serious and stubborn mental condition like bipolar disorder and 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. 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 severity, degree of impairment in functioning, chronicity and disability are some of the factors that differ in the occurrence of combinations of psychiatric disorders alongside substance abuse problems. For example, both disorders could be of the same severity or one could be mild while the other is severe. Truly, the seriousness of both disorders can be modified eventually. Degrees of impairment in functioning as well as disability can also change.

Therefore, it is important to note that there is no single combination of co-occurring disorders; they actually vary depending on the mentioned factors. However, certain treatment settings are often encountered for patients with similar mixtures 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.


Unlike individuals who are diagnosed with mental health disorders or those with alcohol and drug dependency issues alone, those with dual disorders most of the time undergo serious and long lasting medical, emotional and social difficulties. They are vulnerable to both COD relapse and a worsening of the psychiatric disorder because they have two disorders. 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. 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.

Mood disorders, personality disorders, psychotic disorders and anxiety disorders are some of the most common mental disorders present among patients that suffer from co-occurring disorders.