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Co-Existing Conditions


Co-existing conditions which is also referred to as dual diagnosis or dual condition pertains to the existence of more than one medical condition at the same time. For example, an individual may suffer from bipolar disorder as well as substance abuse.

Just as the field of treatment for substance abuse and mental disorders has developed to become more accurate, so too has the terminology used to narrate people with both substance use and mental disorders.


The term co-occurring actually takes the place of the terms dual disorder and dual diagnosis. The said terms although usually used to refer to both drug and mental disorders as accompanying conditions, it can be easily misconstrued since they may also mean the combination of other health conditions like mental ailment or mental delay.

Also, there can be more than just two disorders present, while these terms are implying otherwise. Patients who have coexisting conditions can have one or more conditions associated with alcohol or drug dependency and also one or more mental condition. 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.

Dual disorder is used interchangeably in this article to refer to co-occurring disorders although the latter is the most recent development in the lingo as used in the medical field.


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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. The definition of Mentally Ill Chemically Affected people is liked better as "affected" describes their state better and it isn't 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).

Some typical examples of co-occurring disorders are the combinations of cocaine addiction with major depression, occasional polydrug abuse with borderline personality disorder, panic disorder with alcohol addiction and polydrug addiction and alcoholism with schizophrenia. Whilst the theme of this relates to dual disorders, a few patients suffer from three or even more disorders. The concept that applies to dual disorders normally applies also to multiple disorders.

The existence of combined co-existing conditions and those of psychiatric disorders can differ in several significant aspects like chronicity, gravity, disability and level of impairment in bodily operations. For instance, each of the two disorders may be serious or mild, or one may be more serious than the other. How severe the disorders are also varies with time and is not constant. 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.


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).


Compared patients who have a COD use problem alone or a mental health disorder, and more serious and chronic medical, social and emotional problems are often experienced by the patients with dual disorders. Since they have two disorders, they are at a risk of COD relapse and deterioration of the psychiatric ailment. Further, worsening of psychiatric problems often leads to addiction relapse and addiction relapse often leads to psychiatric decompensation. Thus, for patients with dual disorders relapse prevention must be specially designed. Patients who battle with dual disorders frequently need longer treatment, experience more emergencies and advance more slowly in treatment than patients who battle just a single disorder.

Psychiatric disorders most prevalent among dually diagnosed patients include personality disorders, mood disorders, psychotic disorders, and anxiety disorders.