Co-occurring Disorders

Patients with co-occurring disorders present with one disorder, and additionally often have other disorders that require medical and psychiatric care. It is very common for a person with an eating disorder or psychiatric disorder to have other problems that require our attention. Examples of co-occurring disorders for patients who have an eating disorder include:

• Post-traumatic stress disorder or depression
• Obsessive-compulsive disorder
• Self-harming behavior, such as cutting or burning
• Drug or alcohol addictions

It takes an integrated model of care to treat a person with a co-occurring disorders successfully. Unless co-occurring disorders are treated simultaneously, one disorder may worsen as the other improves.

The Prevalence of Co-occurring Disorders

A diagnosis of co-occurring disorders is an expectation, not an exception for Walden patients. Co-occurring disorders are so common, at Walden Behavioral Care we assume that every patient has a co-occurring disorders until a thorough assessment shows otherwise.

Treating Patients With Co-occurring Disorders

When co-occurring disorders patients are admitted, the treatment team meets to develop and implement a multidisciplinary treatment plan that is frequently reviewed and revised according to the patient's response to the co-occurring disorders treatment.

It is important that all medical and psychiatric issues be identified and treated concurrently. When patient care focuses on just one disorder and fails to deal with issues that led to the disorder, the patient may develop another disorder as a substitute.

A Co-occurring Disorders Model

A "four quadrant" model is used to categorize patients with co-occurring disorders. The model categorizes patients, based on the severity of each individual disorder of their co-occurring disorders. The following model is for patients with co-occurring disorders of a psychiatric disorder (PD) and an eating disorder (ED), but it can also apply to patients with any other co-occurring disorders.

When a patient has co-occurring disorders, neither disorder should be given priority over the other disorder.

Case management and clinical care for patients with co-occurring disorders must be properly balanced with empathic detachment, opportunities for empowerment and choice, contracting and contingent learning. The model says that the identified care that is common for each disorder must be balanced with contingent learning, which is based on trying additional treatment based on past experience, patient history and other factors.

There is no one correct approach to treating individuals with co-occurring disorders. Again, different people have different needs. Each of the patient's co-occurring disorders should be considered individually, and a treatment plan should be developed and implemented by a team of professionals, based on best practice requirements - but with enough flexibility to adjust to the patient. Whatever the patient responds best to is the best plan for treating the patient with co-occurring disorders.

Treatment for patients with co-occurring disorders is still evolving, but Walden Behavioral Care is already experiencing success with the approach outlined here.

Helping Someone Co-occurring Disorders

If you suspect you or someone you know has co-occurring disorders, do something about it. Seek professional counseling immediately.

For help, contact Walden Behavioral Care at 781-647-6700 or Info@waldenbehavioralcare.com.