Dual diagnosis

Dual disorder or dual diagnosis in psychiatry refers to the presence of two distinct illnesses occurring simultaneously. It used almost exclusively to refer to the presence of a substance use disorder such as alcoholism occurring simultaneously with another primary psychiatric illness such as major depression.

Prevalence
Among people who are diagnosed with a serious mental illness such as schizophrenia, almost one in three also struggles with drug or alcohol addiction.

Substance use disorders can be confused with other psychiatric disease. There are diagnoses for substance-induced mood disorders and substance-induced anxiety disorders and thus such overlap can be complicated. For this reason, the DSM-IV advises that diagnoses of primary psychiatric disorders not be made in the absence of sobriety (of duration sufficient to allow for any substance-induced symptoms to dissipate).

Treatment
It can be very difficult to find appropriate treatment opportunities for these people. Most substance-abuse centers do not accept people with serious psychiatric conditions, and many psychiatric centers do not have expertise with substance abuse.