The Complexities of Concurrent Disorders: From its name to the diagnosis, treatment, & understanding
Have you heard about concurrent disorders? Maybe you’ve heard about it from its other international names: dual diagnosis, co-occurring disorder, or co-morbid disorder.
The Canadian accepted term ‘concurrent disorder’ is when an individual is diagnosed with a mental health disorder and a substance use disorder. This disorder is significantly underdiagnosed and undertreated. Traditional healthcare systems typically treat a mental health disorder and addiction separately. Often individuals with concurrent disorders are turned away from utilizing healthcare resources as psychiatrists usually do not have addiction management training, and addiction-treating physicians often don’t treat psychiatric disorders (1). This contributes to an increased risk for mortality and morbidity, as those who seek treatment are left with nowhere to go.
Now you might be thinking, “How relevant is this? If it occurs in enough people, wouldn’t that change the system?”. Up to 80% of individuals with a mental health disorder also have a substance use disorder (2). Certain mental health disorders present different risks for concurrent disorders. For instance, approximately one-fourth of people with anxiety or major depressive disorder will have a co-occurring substance use disorder (3). Whereas, of those with bipolar disorder or schizophrenia, half of these individuals will have a co-occurring substance use disorder (4). Interestingly, cigarette smoking is often not included in these reports, but if they were, this would significantly increase the rate of concurrent disorder prevalence. This data suggests a significant majority of the concurrent disorders in our populations, but this is not reflected in our healthcare systems or research.
Research is often done in ways to control many different variables to get as close to a causal relationship as possible. In this context, concurrent disorders are not very research-friendly. The combination of mental health disorders to substance use disorders is only one complex layer of the puzzle. Adding to this complexity, those with concurrent disorders are more likely to be impacted by multiple biological, psychological, and social risk factors and influence each disorder differently. Concurrent Disorders are complex disorders that have varying clinical progression and symptomology with every individual. Thus, individuals with concurrent disorders are largely excluded from research (1).
The last few decades have shown improvements in the treatment and study of concurrent disorders, but considering the prevalence and severity of the disorder, more needs to be done.
Blog by Tanisse Teale