Difference Between Dual Diagnosis, Integrated Treatment and Co-Occurring Disorders

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Last Updated on May 10, 2021 by

Two Co-occurring disorders may exist simultaneously with medical illness or mental health disorder. Such predicaments are known as dual co-occurring disorders. The presence of CSD, PTSD, and traumatic brain injuries in people with ADHD, as well as a variety of substance use disorders, is comparable to its prevalence in someone without ADHD.

It has been observed that SUDs are associated with the development of other co-occurring disorders. Half of the people with one mental health illness then develop at least one other mental health problem within three years after receiving treatment for their first mental health issue. These co-occurring disorders can also worsen each other’s severity.

These Disorders May Occur for Three Reasons:

  • Combined Risk Factors: There are common factors that contribute to the risk of developing a substance use co-occurring disorder and other mental health problems shared by many of them. Several factors, including genetics and environmental influences linked to these diseases, can either cause a person to be more likely to develop the illness or make him or her more prone to the illness.
  • Self-Medicating: A person struggling with mental illnesses may abuse a substance to cope with symptoms. Self-medicating can be referred to as a concept that may be misleading as substances, while useful at times, may also exacerbate symptoms in both the short and long terms. When individuals self-medicate, they do so to relieve their chronic pain symptoms.
  • The Effects of Drugs on The Formation of Neural Circuits: Substance abuse can alter the human brain, leading to an increase in the likelihood of co-occurring disorders being manifested in certain parts of the brain, especially in adolescent and young adults. There has been some correlation found between those parts of the brain affected by substance use that appear to be involved with impulse control disorders and those afflicted with mood and anxiety disorders.

In recent decades, studies have examined the co-occurring disorders that occur independently. Some studies indicate that substance use disorders overlap more often with mental health disorders.

Substance Abuse Disorders Often Result in Conditions that Are Characterized by Mental Illness, Including

  • Anxiety DisordersA major threat to public safety is a significant rise in socially nervous disorders in the general population. Additionally, it has been determined that an increase in the use of marijuana is associated with interpersonal anxiety disorders. The co-occurring disorders is rather common in generalized anxiety disorders, social anxiety disorders, and severe panic disorders in people with the conditions above, and particularly generalized anxiety disorders, social anxiety disorders, and severe panic disorders.
  • Mood Disorders: In general, around 20% of the general public with a SUD also have bipolar disorder or depression. While several mood disorders will be observed during this period, many SUDs are likely to be assigned to at least one mood disorder.
  • Personality disorders: Over 35% of patients with an alcohol or drug addiction have a personality disorder. In comparison, 15-20% of people in the normal population have a personality disorder, while 15%-50% of people in the “normal population” have personality disorders. Most SUD sufferers are diagnosed with Co-occurring disorders such as paranoid personality disorder, dissociative identity disorder, borderline personality disorder, and obtrusive personality disorder.
  • PostTraumatic Stress Disorder (PTSD): The Centers for Disease Control and Prevention (CDC) published a study that found people with PTSD was four times more likely to be suffering from substance abuse disorders when compared to people who did not have PTSD.
  • Hyperactivity Disorder: According to one study, there is an association between ADHD and substance abuse, which means people with ADHD are at higher risk of substance abuse at a younger age. According to Brook and coworkers, diagnostic scores of ADHD, which are generally first discovered in teenage girls, are associated with increased risks of substance use disorders in adults, a condition known as co-occurring disorders. A person’s likelihood of abusing substances is positively correlated with the number of symptoms he or she demonstrates with attentional deficit hyperactivity disorder (ADHD).

A neuroscientist and a psychologist are rapidly evolving fields that are increasingly important to each other. As we learn more about mental illnesses’ biochemical mechanisms, the terminology we use to understand them will also change over time. Two terms relatively new to addiction treatment are dual diagnosis and co-occurring disorders or “co-existing disorders”.

Despite an increase in the popularity of the term co-occurring disorders over the last decade, an individual with dual diagnoses has been a person with co-occurring disorders, not necessarily all of them co-occurring.

Meaning of Dual Diagnosis?

A woman with a dual diagnosis is one whose immune system and her nervous system are malfunctioning simultaneously while she experiences co-occurring disorders. When someone is diagnosed with Dual Diagnosis, he or she is generally suffering from a dual diagnosis, which is a form of mental health illness and an addiction to drugs or alcohol. It’s not uncommon for an individual with both an alcohol use disorder (alcoholism) and co-occurring disorder to experience the same levels of mental health functioning as someone who has only a specific psychiatric problem. Almost all patients can be diagnosed with both diagnoses simultaneously, which is among the possible scenarios.

There has been a rise in the number of people who have suffered from mental health disorders and substance abuse disorders simultaneously. The National Alliance on Mental Illness (NAMI) says people with mental illnesses often struggle with addiction. Even more so than previously thought, there has been evidence that nearly 29 per cent of individuals with mental illnesses become dependent on drugs or alcohol at some point in their lives. Six out of ten people with a substance use disorder also have a mental health condition accompanied by the co-occurring disorder.

Meaning of Co-occurring Disorder?

The term ‘co-occurring disorder’ is limiting because it describes health problems affecting more than one individual at the same time. One person may be struggling with more than one illness that can be neatly seen and be diagnosed simultaneously. Several clinical disorders can exist concurrently in any individual, which could cause them to suffer from more than one problem. When individuals suffering from both substance misuse and anxiety is also found to have post-traumatic stress disorder or co-occurring disorder, then such individuals are at a higher risk of experiencing difficulties with recovery. It is very common to have more than one psychiatric condition simultaneously.

Studies have found that up to 50% of people with multiple mental illnesses suffer from more than one diagnosable mental illness.


If a patient receives a second diagnosis or a third diagnosis, or even a fourth diagnosis, their treatment will most likely change. When one person suffers from more than one health condition, especially when another aggravates one condition, it can be difficult for them to recover from any of them. An individual with numerous diagnoses is at a greater risk of relapse, and a co-occurring disorder is more difficult to treat than a single diagnosis. Hence, if the disorders remain untreated, increasing symptoms would result. A study by SAMHSA conducted in South Africa showed that approximately 7.9 million American adults suffer from co-occurring disorders, which can appear to be brain diseases or disorders of the nervous system when treated with medication. Due to the complexity of these illnesses, it is best to seek treatment from a professional

Integrating Therapy of Co-Occurring Disorders

In the past, people struggled to find a single safe, supportive environment that can offer addiction treatment and mental health treatment. Unfortunately, patients with addictions were intruded onto psychiatric wards to push into substance abuse treatment centers. The two of them were unable to get the treatment they need for co-occurring disorders since they were forced to stay absent. Patients were left feeling like they were out of power, under pressure, and at risk of dangerous illnesses because this treatment approach was ineffective in delivering healing. People with co-occurring disorders will suffer if one of them isn’t treated, thus affecting everyone around them. It comprises a comprehensive treatment program that encompasses daily life situations and depression, anxiety, and a whole host of mental illnesses.

Aside from mental illness, substance abuse can accompany mental illness as well. This programme aims to give individuals greater awareness of co-occurring disorders and substance abuse problems.

These programs also offer support and treatment for mental illnesses, thus supporting the country’s growing need for mental health personnel. Addictions and co-occurring disorders require specialized treatment to address the whole person, prevent relapses and offer individuals ongoing support.


Several co-occurring disorders can be combined into an overall wellness program by combining different types of treatments. Treatments are put in place to treat co-occurring disorders. Symptoms treated with this type of treatment can include physical trauma and psychological trauma, treatment of physical symptoms and management of illnesses that result from psychological trauma and physical illness, and case management during symptom treatment.
A co-occurring disorders/illness that is effectively treated by a team of experts by integrating treatment methods is more effective since they tend to react together. One patient who is not treated for one condition may develop another severe problem that can be quite dangerous for his or her overall health. A combination of treatments can benefit patients who have more than one ailment.


Also included in healthcare teams are physicians, counselors, therapists, case managers, coaches, mental health workers, and other health professionals who work with co-occurring disorders. The field of mental illness and addiction has various professionals who specialize in treating and identifying these illnesses in various forms. These professionals often operate within certain cycles and are trained in identifying and treating these conditions. The specialists, including doctors, nurses, dietitians and therapists, offer a purposeful approach to healing and wellness for co-occurring disorders.


Incorporating co-occurring disorders into a treatment that focuses on the whole person is effective not just in treating patients dealing with physical and behavioral difficulties but also in those dealing with emotional and physical difficulties. It is important to interact with your chosen treatment program about these conditions and recovery from addiction and mental illness if you or your care provider do not know anything about their co-occurring disorders.

We can assist you in finding the right treatment to suit your particular needs, as well as offering guidance on the process of getting started. Call our toll free number 615-490-9376 to get connected with one of our staff personnel available 24 hours a day, seven days a week, seven days each month to help individuals who require assistance. If you have questions regarding treatment or have any concerns about your health, you can discuss it with the doctors on the staff of matters concerning co-occurring disorders.

Citation

 Gorman, C. “Bad Trips for the Doubly Troubled.” TIME Magazine. 3 August 1987. Accessed 2 Aug 2017.

2 Substance Abuse and Mental Health Services Administration. Co-occurring Disorders. Mar 2016. Accessed 2 Aug 2017.

3 White, D. Living with Co-occurring disorder & Substance Abuse Disorders. October 2013. Psych Central. Accessed 2 Aug 2017.

4 Volkow, N. Addiction and Co-occurring Mental Disorders. National Institute on Drug Abuse. 2007. Accessed 2 Aug 2017.

5 Kelly, Thomas M., and Dennis C. Daley. Integrated Treatment of Substance Use and Psychiatric DisordersSocial Work in Public Health. 2013: 388–406. PMC. Web. Accessed 2 Aug 2017.

6 Somers, J., Moniruzzaman, A., Rezansoff, S., Brink, J. The Prevalence and Geographic Distribution of Complex Co-occurring Disorders: a Population Study. Epidemiology and Psychiatric Sciences, Volume 25, Issue 3 June 2016, pp. 267-277. Accessed 2 Aug 2017.

7 Pettinati, H., O’Brien, C., Ph.D. Dundon, W. Current Status of Co-occurring Mood and Substance Use Disorders: A New Therapeutic Target. The American Journal of Psychiatry. Vol 170, Issue 1, Jan 2013, pp. 23-30. Accessed 2 Aug 2017.