Co-occurring Disorders
By Jake Kohl
Co-occurring disorders
formerly known as dual-diagnosis or dual disorder describes the existence of
two or more disorders at the same time (Psychology Today, 2012). Clients that
are suffering from this disorder have conditions that consist of one or more forms
of substance abuse along with a mental illness or an illness in general such as
AIDS and even other physical disorders (Doweiko, 2012, p. 317).
Co-occurring disorders must not be ruled out when assessing a client; rather, it should always be in the back of the professionals mind in making a clear plan of recovery. Doweiko states that “the assessor must have the ability to distinguish the signs and symptoms of the primary psychiatric illness from those caused or exacerbated by a primary SUD (p. 317). If the assessor does not have the ability to distinguish between the two, it can create a recovery that will repeat its cycle of abuse.
Three examples of co-occurring disorders
are Attention Deficit Hyperactivity Disorder (ADHD), Schizophrenia, and Anxiety
Disorders. ADHD, thought to be as prevalent as asthma, affecting 4-5% of the
population (Doweiko, 2012, p. 321) is a “neurobehavioral disorder characterized
by a combination of inattentiveness, distractibility, hyperactivity, and
impulsivity” (Psychology Today, 2012). ADHD’s relationship to SUD is quite
staggering. It was suggested that 21% of adults with ADHD to have a con-current
cocaine use disorder (p. 321). Research suggests that children with ADHD have a
higher percentage chance of having an SUD into adulthood and with the two, an
active substance abuse problem can make the diagnosis of ADHD difficult (p.
321-322). The relationship between these two co-occurring disorders calls for
more research to further argue that they are indeed a confounding.
The second example of co-occurring
disorders is schizophrenia. According to Psychology Today, schizophrenia is a
disabling, chronic, and severe mental illness that affects more than 2 million
Americans age 18 and over (2012). Interesting is the fact that “40 to 50% of
patients with schizophrenia also have a concurrent SUD” (Doweiko, 2012, p.
322). The most abused substance with those suffering from schizophrenia is
alcohol (p. 322) and this may be related to the poor treatment to the mental
disorder. Cocaine use has a more intense feeling of craving from those with
schizophrenia during withdrawal (p. 323). Treating one disorder without the
other, will greatly impact the positive results from treatment, or lack
thereof.
The third example of co-occurring
disorders is Anxiety. Anxiety according to Psychology Today, “is a normal reaction
to stressful situations; But in some cases, it becomes excessive and can cause
sufferers to dread everyday situations” (2012). Doweiko (2012) suggests that
the relationship between anxiety and an SUD is “quite complicated” (p. 323).
Rightly so, the drugs of abuse can induce anxiety as either a side effect or
result from withdrawal (p. 323). The complication arises when trying to
determine what is excessive. Doweiko points out that “one point that assists in
the differentiation between substance-induced anxiety and anxiety disorders are
thought to predate the development of the SUD” (p. 323).
The three co-occurring disorders are all closely
related and linked to SUD’s and deserve to be looked at and researched more in
depth. Further studies will allow for more insightful research that can help
treat those affected by the dual-diagnosis of disorders to effectively treat
each person and the condition(s) they have. The assessors must accurately
assess each individual and make a clear diagnosis of each disorder to begin
treatment. Often, these disorders are overlooked making treatment ineffective
and the abuser to continue to abuse or relapse in the abusive cycle.
Reference
Doweiko, H. E. (2012). Concepts
of chemical dependency. (8th ed.). Belmonte, CA: Brooks/Cole Pub Co.
Co-ocurring disorders.
(2012). Retrieved from http://www.psychologytoday.com/conditions/co-occurring-disorders
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