Primary diagnosis? Substance dependance?

So this past week I went and completed a question and answer thing and watched a few videos on smoking cessation that it turned out I’d participated in the beta phase for in the first place. So anyway I’m there and after completing the thing I’m talking to the woman and she says “Well lets look up your info just to see something” Or along those lines…

And she says “Well it looks like you have a primary diagnosis of substance dependence”…whaaaaat? That has been a secondary diagnosis for years now…but primary? I don’t even know what this might imply. So I didn’t qualify for the smoking cessation group as I didn’t have enough sobriety…fair enough I suppose.

But what happened to my primary diagnosis of schizophrenia? Did they take my schizophrenia away???

I might be out on a limb but it sort of sounds like they were just looking at smoking and other substances … not anything more then that.

so for that small sampling… they only see the smoking and anything other addictions… not any of the mental illness.

That’s just my odd brain looking at it.

Having a primary dx doesn’t exclude having a secondary one. Might your schizophrenia have improved to be put in a secondary position, or your substance dependence worsened to be put in a primary position?

Both my psychiatrist and psychologist dont put down my secondary diagnosis - they dont bother.
My therapist told me that a lot of pdocs and therapists dont even mention a secondary dx to the insurance companies - I have other dxes besides bipolar and that would be OCD GAD and Panic disorder/agoraphobia
I have a strong feeling that my pdoc did not change the diagnosis of Schizoaffective on paper to the Insurance company - she just told me verbally that I suffered from bipolar disorder mixed - I wonder why she would do this?

Hmm…yes this could be it…my Sz has improved to the point of nearly being a non-issue in recent years…while my substance use has not worsened it is still an issue at times…so maybe that’s why. I just didn’t think for some reason that something as serious as Sz could even BE a secondary diagnosis…

Psychiatry has a language all of its own. Do you know what a “thought disorder” might be? In psychiatric parlance, it means you talk funny! I would not assume that I knew what they were talking about when they said “primary diagnosis” or “secondary diagnosis”.



I wonder if the diagnoses is schizophrenia with substance dependence, which could make both primary? My son’s addiction is considered a concurrent disorder so happening at the same time and of equal concern. At least that is how I interpret it.