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 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.
Dual disorder and dual diagnosis terms are replaced by 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. Patients who have coexisting conditions can have one or more conditions associated with alcohol or drug dependency and also one or more mental condition. Co-occurring disorders can be diagnosed when a minimum of one disorder of each kind can be verified separate from the other disorder and it's not just a group of symptoms that stem from one of the disorders.
In this article, the term dual disorders will also be used, even though the term co-occurring disorders is currently utilized among professionals.
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 better word that is more preferred in terms of its connotation is Mentally Ill Chemically Affected. 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. 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.
The mixture of psychiatric disorders and COD problems differ along important dimensions like chronicity, disability, severity, and degree of impairment in functioning. As an example, both disorders can be mild or serious or one disorder can be more serious than the other disorder. However, with time, the extremity of both disorders might change. 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. This is not to rule out the fact that one can come across patients who have the same combination of disorders in the course of treatment.
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. 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. 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.
Mental disorders that are most common amongst dually diagnosed people are personality disorders, mood disorders, psychotic disorders and mood disorders.