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24 hours rehab
Immediate Access for help and advice

Dual Diagnosis (Co-Occurring Disorders)

Dual diagnosis is a medical concept discovered in 1980 among people with coexisting serious mental illness and substance abuse disorders. (1)

The Substance Abuse and Mental Health Services Administration uses the term co-occurring disorders to refer to substance-related and mental disorders that occur simultaneously. Those who have been diagnosed with a dual diagnosis or with co-occurring disorders would have a substance-associated disorder and one or more mental disorders.

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What Is Dual Diagnosis?

Dual diagnosis is the term used when we have been diagnosed with one or more mental health disorders, such as anxiety, personality disorder or depression, alongside substance use disorder like alcoholism or opioid abuse. Dual diagnosis is also referred to as comorbidity.

For instance, we can be addicted to sex, drugs, alcohol or a combination of these and also have a psychiatric disorder such as schizophrenia, depression or borderline personality disorder. Dual diagnosis treatment addresses both conditions so that a full and lasting recovery can be achieved.

Substance use disorders and psychiatric disorders would vary in severity. Those who suffer from co-occurring disorders may require intense and longer treatment because of the difficult physical and mental health challenges.

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What Causes Co-Occurring Disorders?

Co-occurring disorders are caused by a combination of internal and external factors. Some of these factors may be environmental or genetic.


Medical research shows that genetics play a critical role in addiction and mental health problems. (2) A person from a family that has a history of addiction or depression is likely to be vulnerable to such problems; multiple causes and reasons would play a part in this.

Modern scientific investigations on the genetics of addiction have revealed that individual genes, as well as gene networks, seem to operate differently in people suffering from addiction compared to individuals who have not been exposed to drug abuse. Furthermore, people who are exposed to substances or toxins while in the womb have an increased likelihood of struggling with mental challenges later in life. (3)


The environment is an external factor that causes co-occurring disorders. Children who have been raised in homes where drugs and alcohol are used freely may end up using the substances because they think such behaviour is acceptable.

Mental illness may arise due to numerous environmental influences such as stressful events like divorce, death of a loved one, financial pressure, exposure to certain drugs or chemicals and traumatic experiences like terrible traffic accidents and physical or sexual abuse.

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Other risk factors

  • Family history of substance abuse or addiction
  • Low self-esteem or poor self-image
  • Prenatal exposure to certain drugs, toxins and viruses
  • Family history of mental illness
  • Gender (men are said to be more likely to require treatment for dual diagnosis) (4)

Types of Co-Occurring Disorders

  • Mood Disorders: This is an extensive category of mental disorders that includes all types of depression and bipolar disorders.
  • Anxiety Disorders: Anxiety and fear are ordinary feelings. However, constant and extended anxiety feelings that intensify over time may be a symptom of an anxiety disorder.
  • Psychotic Disorders: Psychotic disorders are associated with delusions and hallucinations.
  • Eating Disorders: This is a serious mental illness that makes a person engage in destructive eating behaviours.
  • Personality Disorders: Personality disorders include schizoid, schizotypal, narcissistic and histrionic personalities, among many others.
  • Behavioural Disorders: These include attention deficit, hyperactivity, conduct and oppositional disorders.


(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880934/
(2) https://www.tandfonline.com/doi/abs/10.1300/J374v03n02_05
(3) https://www.webmd.com/baby/qa/what-are-the-effects-of-drugs-on-an-unborn-child
(4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665097/

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