Co-occurring disorders (or dual diagnosis as it is formerly known) refers to the presence of two or more disorders at one time (often some form of substance abuse e.g. alcohol dependency, and a mental disorder, e.g. depression). These disorders often occur independently of one another, with one precipitating the development of the other. In terms of what develops, it can vary from person to person. For example a person who develops a personality disorder during childhood and into adolescence, may turn to substances such as illegal drugs or alcohol as a means of self-medicating their mental problems and in turn develop a dependency on that substance. Likewise a person who develops a drug addiction may in turn develop a psychological disorder such as psychoticism, as a direct result of their drug misuse.
According to Medline plus, there are an estimated are an estimated 8.9 million Americans living with a co-occurring disorders today. With this in mind, there are a number of factors that make an individual more vulnerable to developing a co-occurring disorders. These include biological vulnerabilities (e.g. hard-wired to seek alcohol/drugs), genetic vulnerabilities (e.g. it runs in the family), following significant trauma (e.g. following sexual or physical abuse), a person’s environment (e.g. if a person lives in an environment where drugs are readily available), and that person’s life experience (e.g. how well a person looks after their health).
Often people with co-occurring disorders do not gain access to the appropriate services for treatment. Treatment for individuals with co-occurring disorders can be complex due to the necessity of managing each element of the presentation. The substance abuse element needs to be treated through medical detox while the mental disorder element requires an intervention which may be based on prescribed medication and or/ psychotherapy. This becomes even more complex when you consider that a person presenting with co-occurring disorders may have co-morbid or more than one substance abuse or mental disorders. As such an integrated approach to treatment is best recommended.
An integrated treatment plan combines strategies from psychiatry, psychology and addiction treatment in order to treat co-occurring disorders simultaneously. This treatment incorporates effective evaluation and diagnosis strategies, a medical detox, and personal and/or group psychotherapy. Each individual is provided with a treatment plan personalized for their unique presentation. Research has demonstrated that this combined form of treatment is more effective than stand-alone medical detox or psychiatric approaches (e.g. Tiet and Schutte, 2012).
For further information regarding co-occurring disorders and treatment options, please see the following links:
The American Addiction Centers information on co-occurring disorders
The American Addition Centers information on treating depression and substance abuse http://americanaddictioncenters.org/treating-depression-substance-abuse/
Treatment setting and outcomes of patients with co-occurring disorders (Tiet, Q.Q., & Schutte, K.K. 2012)
Ms. Niamh Allen, M.A. B.Sc.