What is Dual Diagnosis and Comorbidity?
In simple terms, dual diagnosis is the condition of suffering from a mental disorder and at the same time having a co-morbid substance abuse problem.
In the medical world, co-morbidity is the term used to refer to the presence of one or more disorders or diseases co-occurring with a primary disorder/disease.
Does Dual Diagnosis and Co-morbidity Mean The Same Thing?
There have been questions on whether these terms can be used interchangeably and whether they do any justice when it comes to describing the conditions at hand.
For instance, it has been argued that dual diagnosis may be an inappropriate term because it unfairly generalizes heterogeneous groupings of people with varying needs and also because sometimes there are more than two disorders at hand.
As such, co-occurring disorders or COD has been accepted as a more appropriate term to describe a situation where mental disorders and substance abuse problems occur simultaneously in an individual.
There are several instances of co-occurring disorders which can be used as examples of dual diagnosis.
- When major depression exists in an individual suffering from cocaine addiction
- When someone who is addicted to alcohol suffers from panic disorder
- Where schizophrenia and alcohol addiction together with poly-drug addiction occur in the same individual
- Where one suffers from borderline personality disorders and episodic poly-drug abuse
What are the Challenges?
It is often a challenge to diagnose a primary psychiatric disorder in clients with COD because substance abuse often induces the same psychiatric symptoms.
As such, it is important to diagnose substance induced illness and pre-existing illness.
The usual routine followed is that for the pre-existing illness/primary psychiatric disorder to be diagnosed, there has to be sobriety.
That is to say that the concerned medical professional must wait at least a year to give the client enough time for substance-induced symptoms to dissipate.
Some Quick Facts About Dual Diagnosis/COD
- There is no single combination of dual disorders. In fact, great variability has been recorded as far as the combinations are concerned.
- More than half of all adults with severe mental illness suffer from substance abuse, be it alcohol or other drugs.
- Patients with dual diagnosis face far greater emotional, social and medical problems compared to those who suffer from mental illness alone or substance abuse alone. This includes having a higher chance of relapse after drug and alcohol treatment.
- The most common psychiatric disorders that exist in clients who are dual diagnosed include mood disorders, anxiety disorders, psychotic disorders and personality disorders.
As with most fields, there have emerged certain terms that are used to describe varying types of individuals encountered during dual diagnosis or COD. These include:
- MICA is an acronym for Mentally Ill Chemical Abusers. This term is used to refer to individuals who have a COD and a severe and persistent mental disorder such as bipolar disorder or schizophrenia. Some people prefer to use the term mentally ill chemically affected people as it is less pejorative.
- MISA is another acronym that is commonly used. It stands for mentally ill substance abusers.
- SAMI (substance abuse and mental illness) and CAMI(chemical abuse and mental illness) are other acronyms you might want to be familiar with.
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