An Introduction to Dual Diagnosis and Dual disability

By Rajalakshmi Rahul on October 24, 2011

Dual diagnosis is nothing but addiction to alcohol accompanied by any other mental disorder such as depression, anxiety or Schizophrenia [Rassool H, 2002]. Dual diagnosis is a serious issue under consideration because of its complexity and the risk involved in curing the same. Substance Abuse and mental illness are related to each other in one or the other way. Extreme consumption of drugs such as alcohol and other narcotic drugs may lead to mental disorders. However the converse does not hold true. People with dual diagnosis should be looked after with utmost care since it is not easy to help a person recover from drug addiction who is also suffering from mental disorder. Drugs in general create some type of problems known as “Withdrawal symptoms”, when tried to be given up. People suffering from mental disorder have a greater impact on their health if they are made to come out of the substance abuse.

Dual diagnosis as the name suggests denotes the diagnosis of a problem or mental disorder caused by a person due to more than one drug [Watkins T, 2000]. In most cases the primary drug for which a person might easily get addicted to is alcohol. Research has shown that at least one out of five people between the age groups 16 and 59 are prone to alcoholic addiction [Usnodrugs, Website].

Treating a person with dual diagnosis is one of the greatest challenges; medical world is facing for the past few decades.

According to reports published in the Journal of the American Medical Association:

  • Fifty percent of individuals with severe mental disorders are found be affected by substance abuse.
  • Of all the people diagnosed as mentally ill, Twenty nine percent abuse either alcohol or drugs. [NAMI, Website]
  • 37% percent of alcohol abusers and fifty three percent of drug abusers also have at least one serious mental illness.

Dual Disability:

Dual disability is the case when a person suffers from intellectual disability and mental disorder. Historically both intellectual disability and psychiatric or mental illness was considered as a single entity. As science developed, researchers began to separate these two things. After too much of research, researches have ended up in the following findings.

Intellectual Disability:

The international definition for intellectual disability has three criteria:

  • Significant limitations in intelligence (classified as an IQ level of 70 or below).
  • Significant limitations in the skills needed to live and work in the community including difficulties with communication, self-care, social skills, safety and self-direction.
  • These limitations in intelligence and living skills are evident in the developmental period (i.e. before the person is aged 18 years).


Mental disorder:

Mental disorder on the other hand no proper definition or meaning. No one has so far determined the starting point of depression in a human body. However, people are classified as psychiatry patients based on the erratic behavior that they exhibit which is something beyond the behavior exhibited by a normal human being.

Dual disability is the case when intellectual disability and mental disorder coexist in an individual. This condition is also termed by professionals as, “Serious mental illness” [Gamble C, 2006]. This behavior is of greatest concern to medical practitioners and mental health social workers, since it is extremely difficult to handle people who suffer from dual disability.


  1. Usnodrugs, Available at,, Accessed on 3rd October 2011
  2. Ted R. Watkins, Ara Lewellen, Marjie Crow Barrett, Dual diagnosis: an integrated approach to treatment, SAGE, 2000
  3. Hussein Rassool, Dual diagnosis: substance misuse and psychiatric disorders, Wiley-Blackwell, 2002
  4. NAMI, Available at,, Accessed on 3rd October 2011
  5. Katie Evans, J. Michael Sullivan ,Dual diagnosis: counseling the mentally ill substance abuser, Guilford Press, 2001
  6. Catherine Gamble, Geoff Brennan, Working with serious mental illness: a manual for clinical practice, Elsevier Health Sciences, 2006
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