UNDERSTANDING WOMEN WITH CO-OCCURRING DISORDERS Presenting Problems and History

Approximately five million adults in the United States have co-occurring disorders (Substance Abuse and Mental Health and Human Services Administration [SAMHSA], 2006). “Co-occurring disorders” denotes the simultaneous diagnosis of a substance use disorder and a serious mental illness. An individual with co-occurring disorders may have one or more substance use disorder in addition to one or more serious mental illness (SAMHSA, 2006). A substance use disorder includes abuse or dependence on alcohol or other drugs as classified in the Diagnostic and Statistical Manual of Mental Disorders 4th edition Text Revision (DSM-IV-TR) (American Psychiatric Association [APA], 2000). A serious mental illness includes a mental, behavioral or emotional disorder that an individual is currently presenting or has presented within the last year. A serious mental illness also meets criteria specified in the DSM-IV-TR (APA, 2000; Center for Substance Abuse Treatment [CSAT], 2007a) resulting in functional impairment that substantially interferes with or limits one or more major life activities including self care, mobility, social and family life, educational and vocational performance, and community participation (CSAT, 2007a; Kessler et al., 2003).