Causes of mental disorders

Source: Wikipedia, the free encyclopedia.
Image 1: The prevalence of mental illness is higher in more unequal rich countries

A

environmental factors that can contribute to the development or progression of mental disorders.[5] Most mental disorders result in a combination of several different factors rather than just a single factor.[6]

Research results

Risk factors for mental illness include

alcohol, and caffeine
.

Mental illnesses have risk factors, for instance including unequal parental treatment, adverse life events and drug use in

impulse and other emotional control
.

In February 2013, a study found genetic links between five major psychiatric disorders:

preeclampsia, or infection) and birth have also been implicated.[9] Traumatic brain injury
may increase the risk of developing certain mental disorders. Throughout the years, there have been inconsistent links found to certain viral infections, substance misuse, and general physical health that have been false.

Adverse experiences affect a person's

cultures. Mental stress is a common cause of mental illnesses, so finding a coping solution to cope with mental stress
would be beneficial. Many solutions that have helped reduce stress are yoga, exercise, and some medications that may help.

Theories

General theories

Several

theories or models seek to explain the causes (etiology) of mental disorders. These theories may differ in regards to how they explain the cause of the disorder, how to treat the disorder, and how they classify mental disorders. Theories also differ about the philosophy of mind they accept; that is, whether the mind and brain
are identical or not.

During most of the 20th century, mental illness was ascribable to problematic relationships between children and their parents. This view was held well into the late 1990s, in which people still believed this child-parent relationship was a large determinant of severe mental illness, such as depression and schizophrenia. In the 21st century, additional factors have been identified such as genetic contributions, though experience also plays a role. So, the perceived causes of mental illness have changed over time and will most likely continue to alter while more research develops throughout the years.

Outside the West, community approaches remain a focus.

A practical mixture of models will explain particular issues and disorders, although there may be difficulty defining boundaries for indistinct psychiatric

syndromes
.

Medical or biomedical model

An overall distinction is also commonly made between a "medical model" (also known as a biomedical or disease model) and a "social model" (also known as an empowerment or recovery model) of mental disorder and disability, with the former focusing on hypothesized disease processes and symptoms, along with latter focusing on hypothesized social constructionism and social contexts.

brain circuits shaped by a complex interplay of genetics and experience.[12]

The social and medical models of mental disorders each work to identify and study distinct aspects, solutions, and potential therapies of disorders. The intersection and cross reference between the two models can further be used to develop more holistic models of mental disorders. Many criticisms historically of each model is the exclusivity of the other perspective. Therefore, intersectional research improved the impact and importance of future findings.[13]

Biopsychosocial model

The primary model of contemporary mainstream Western psychiatry is the biopsychosocial model (BPS), which integrates biological, psychological, and social factors.[11] The Biopsychosocial model was first conceptualised by George Engel in 1977,[14] suggesting that to understand a person's medical condition it is not simply the biological factors to consider, but also the psychological and social factors . The biopsychosocial approach systematically considers biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery. Biological, psychological, and social factors exist along a continuum of natural systems. The factors within the model contain the following:

  • Biological (physiological pathology)
  • Psychological (thoughts emotions and behaviours such as psychological distress, fear/avoidance beliefs, current coping methods and attribution)
  • Social (socio-economical, socio-environmental, and cultural factors such as work issues, family circumstances and benefits/economics)

This model is commonly used for case conceptualization of psychological disorders as well as chronic pain,[15] with the view that the pain is a psychophysiological behavior pattern that cannot be categorised into biological, psychological, or social factors alone.

A related view, the

diathesis-stress model, posits that mental disorders result from genetic dispositions and environmental stressors, combining to cause patterns of distress or dysfunction.[16]
The model is one way to explain why some individuals are more vulnerable to mental disorders than others. Additionally, it explains why some people may develop a mental disorder after exposure to stressful life events while others do not.

Psychoanalytic theories

superego. The id operates under the pleasure principle, the ego operates under the reality principle, and the superego is the "conscience" and incorporates what is and is not socially acceptable into a person's value system.[17] According to the psychoanalytic theory, there are five stages of psychosexual development that everyone goes through the oral stage, anal stage, phallic stage, latency stage, and genital stage. Mental disorders can be caused by an individual receiving too little or too much gratification in one of the psychosexual developmental stages. When this happens, the individual is said to be in that developmental stage.[18]

Attachment theory

disorganized disoriented attachment.[21] Secure attachments reflect trust in the child-caretaker relationship while insecure attachment reflects mistrust. The security of attachment in a child affects the child's emotional, cognitive, and social competence later in life.[20]

Evolutionary psychology

See also: Evolutionary psychiatry

great apes
).

Other theories suggest that mental illness could have evolutionary advantages for the species, including enhancing creativity

flight-or-fight response
in anticipation of danger.

Bipolar Disorder and explain the relationship between light and seasonal affective disorder
.

Biological factors

Biological factors consist of anything physical that can cause adverse effects on a person's mental health. Biological factors include genetics, prenatal damage, infections, exposure to toxins, brain defects or injuries, and substance abuse. Many professionals believe that the cause of mental disorders is the biology of the brain and the nervous system.

Mind mentions genetic factors, long-term physical health conditions, and head injuries or epilepsy (affecting behavior and mood) as factors that may trigger an episode of mental illness.

Genetics

Some rare mental disorders are caused only by genetics such as Huntington's disease.

Family linkage and some

alleles
(forms of genes) were responsible for this disorder. Some research has indicated only multiple, rare mutations are thought to alter neurodevelopmental pathways that can ultimately contribute to schizophrenia; virtually every rare structural mutation was different in each individual.

Research has shown that many conditions are polygenic meaning there are multiple defective genes rather than only one that is responsible for a disorder, and these genes may also be pleiotropic meaning that they cause multiple disorders, not just one.

Alzheimer's are both examples of hereditary mental disorders. When exonic genes encode for proteins, these proteins do not just affect one trait. The pathways that contribute to complex traits and phenotypes interact with multiple systems, even though proteins have specific functions.[26]
brain plasticity (neuroplasticity) raises questions of whether some brain differences may be caused by mental illnesses or by pre-existing and then causing them.

Attention deficit hyperactivity disorder

This section is an excerpt from Attention deficit hyperactivity disorder § Genetics.[edit]

In November 1999,

sex ratio in the epidemiology of autism as an analogue.[29][30][31]

Natural selection has been acting against the genetic variants for ADHD over the course of at least 45,000 years, indicating that it was not an adaptative trait in ancient times.[32] The disorder may remain at a stable rate by the balance of genetic mutations and removal rate (natural selection) across generations; over thousands of years, these genetic variants become more stable, decreasing disorder prevalence.[33] Throughout human evolution, the EFs involved in ADHD likely provide the capacity to bind contingencies across time thereby directing behaviour toward future over immediate events so as to maximise future social consequences for humans.[34]

ADHD has a high

polygenic and arises through the combination of many gene variants which each have a small effect.[35][36] The siblings of children with ADHD are three to four times more likely to develop the disorder than siblings of children without the disorder.[37]

The association of maternal smoking observed in large population studies disappears after adjusting for family history of ADHD, which indicates that the association between maternal smoking during pregnancy and ADHD is due to familial or genetic factors that increase the risk for the confluence of smoking and ADHD.[38][39]

ADHD presents with reduced size, functional connectivity and activation

7 repeat variant of dopamine receptor D4 (DRD4–7R) causes increased inhibitory effects induced by dopamine and is associated with ADHD. The DRD4 receptor is a G protein-coupled receptor that inhibits adenylyl cyclase. The DRD4–7R mutation results in a wide range of behavioural phenotypes, including ADHD symptoms reflecting split attention.[50] The DRD4 gene is both linked to novelty seeking and ADHD. The genes GFOD1 and CDH13 show strong genetic associations with ADHD. CHD13's association with ASD, schizophrenia, bipolar disorder, and depression make it an interesting candidate causative gene.[51] Another candidate causative gene that has been identified is ADGRL3. In zebrafish, knockout of this gene causes a loss of dopaminergic function in the ventral diencephalon and the fish display a hyperactive/impulsive phenotype.[51]

For
SNARE complex of the synapse can reliably predict a person's response to stimulant medication.[51] Rare genetic variants show more relevant clinical significance as their penetrance (the chance of developing the disorder) tends to be much higher.[52] However their usefulness as tools for diagnosis is limited as no single gene predicts ADHD. ASD shows genetic overlap with ADHD at both common and rare levels of genetic variation.[52]

Bipolar disorder

This section is an excerpt from Bipolar disorder § Genetic.[edit]

first-degree relatives of those with bipolar disorder than in the general population; similarly, the risk of major depressive disorder is three times higher in relatives of those with bipolar disorder than in the general population.[54]

Although the first

multiple testing.[58] On the other hand, two polymorphisms in TPH2 were identified as being associated with bipolar disorder.[59]

Due to the inconsistent findings in a

CACNA1C, GNG2, and ITPR2.[62]

Bipolar disorder is associated with reduced expression of specific DNA repair enzymes and increased levels of oxidative DNA damages.[63]

Prenatal damage

Any damage that occurs to a fetus while still in its mother's womb is considered prenatal damage. Mental disorders can develop if the pregnant mother uses drugs or alcohol or is exposed to illnesses or infections during pregnancy. Environmental events surrounding

obstetric birth complications, infections, and gestational exposure to alcohol or cocaine. These factors have been hypothesized to affect areas of neurodevelopment, general development, and restrict neuroplasticity
.

Infection, disease and toxins

Infection

There have been some findings of links between infection by the parasite Toxoplasma gondii and schizophrenia.[64]

AIDS has been linked to some mental disorders. Research shows that infections and exposure to toxins such as HIV[65] and streptococcus cause dementia.[66] This HIV infection that makes its way to the brain is called encephalopathy which spreads itself through the brain leading to dementia.[65] The infections or toxins that trigger a change in the brain chemistry can develop into a mental disorder.

Depression and emotional liability may be also be caused by babesiosis.

There is some evidence that there may be a relationship between BoDV-1 infection and psychiatric disease.

The research on Lyme disease caused by a deer tick and toxins is expanding the link between bacterial infections and mental illness.[67]

Disease

Depression, anxiety, mania, psychosis, vegetative symptoms, cognitive deficit and consciousness impairment may be caused by internal disease as well as endocrine and metabolic disorders, deficiency states and neurologic disorders.[68]

Injury and brain defects

Any damage to the brain can cause a mental disorder. The brain is the control system for the nervous system and the rest of the body. Without it, the body cannot function properly.[69]

Increased mood swings, insane behavior, and substance abuse disorders are

social influences
.

Head trauma classifies as either open or closed head injury. In

abstract reasoning ability, judgment, memory, and marked personality changes. Open injury head trauma symptoms tend to be the experience of classic neuropsychological syndromes like aphasia, visual-spatial disorders, and types of memory or perceptual disorders
.

extrinsic (grows on the external surface of the brain and produces symptoms as a result of pressure on the brain tissue). Progressive cognitive changes associated with brain tumors may include confusion, poor comprehension, and even dementia. Symptoms tend to depend on the location of the tumor in the brain. For example, tumors on the frontal lobe tend
to be associated with the sign of impairment of judgment, apathy, and loss of the ability to regulate/modulate behavior.

Findings have indicated abnormal functioning of

major depression
, possibly worsening with time depression.

Generic Neurotransmitter System

Neurotransmitter systems

Abnormal levels of

monoamine
neurotransmitters show an association with depression and other psychiatric disorders, but "... it should be questioned whether 5-HT [serotonin] represents just one of the final and not the main, factors in the neurological chain of events underlying psychopathological symptoms...."

Simplistic "chemical imbalance" explanations for mental disorders have never received empirical support; and most prominent psychiatrists, neuroscientists, and psychologists have not espoused such ill-defined, facile etiological theories. Instead, neurotransmitter systems have been understood in the context of the

biopsychosocial models
. The following 1967 quote from renowned psychiatric and neuroscience researchers exemplifies this more sophisticated understanding (in contrast to the woolly "chemical imbalance" notion).

Whereas specific genetic factors may be of importance in the etiology of some, and possibly all, depressions, it is equally conceivable that early experiences of the infant or child may cause enduring biochemical changes, that may predispose some individuals to depressions in adulthood. It is not likely that changes in the metabolism of the biogenic amines alone will account for the complex phenomena of normal or pathological affect.

Substance abuse

Substance abuse, especially long-term abuse, can cause or exacerbate many mental disorders.

anxious
.

Correlations of mental disorders with drug use include

thinking and memory. Alcohol is a problem in many countries due to many people participating in excessive drinking or binge drinking
.

Environmental factors

See also: Social determinants of health, Social determinants of health in poverty, and Social determinants of mental health

The term "environment" is very loosely defined in the context of mental illnesses. Unlike biological and psychological causes, environmental causes denote a wide range of stressors that individuals experience in everyday life. They are more psychologically than biologically based.[70] Events that evoke feelings of loss are the most likely to cause a mental disorder to develop in an individual.[10]

Environmental factors include but are not limited to dysfunctional home life, poor interpesonal relationships, substance abuse, not meeting social expectations, low self-esteem, and poverty.[10] The British charity organisation Mind lists childhood abuse, trauma, violence, neglect, social isolation, discrimination, grief, stress, homelessness, social disadvantage, debt, unemployment, caring for a family member or friend, and significant trauma as an adult (such as war, an accident, or being the victim of a violent crime) as possible triggers of an episode of mental illness.[71]

Repeating generational patterns, behaviors that passed down through different familial generations, are also a risk factor for mental illness, especially in children.[72]

Life events and emotional stress

Mistreatment in childhood or adulthood (including

emotional abuse, domestic violence, and bullying) has been linked to the onset of mental disorders through an interaction of societal, familial, psychological, and biological factors. More generally, negative or stressful life events have been implicated in the development of a range of disorders, including mood and anxiety disorders.[73][74]

The main risks appear to be from the accumulation of such experiences over time, although a single major trauma can sometimes lead to disorders, especially post-traumatic stress disorder. Resilience to such experiences varies; a person may be resistant to some stressors but not to others. The psychological resilience of an individual can be affected by genetics, temperamental characteristics, cognitive flexibility, coping strategies, and previous experiences.[75] For example, in the case of bipolar disorder, stress is not a specific cause but does place genetically and biologically vulnerable people at risk for more severe forms of the illness.[76][77]

Adverse childhood experiences

Main article: Adverse childhood experiences
Further information: Stress in early childhood and Childhood schizophrenia

The Adverse Childhood Experiences Study has shown a strong

toxic stress.[79]

ACEs may affect the structural and functional development of the brain and lead to abnormalities, and

cognitive deficit is more related to neglect than other forms of adversity.[83][84]

Poor parenting is a risk factor for depression and anxiety. Separation, grief in families, and other forms childhood trauma are risk factors for schizophrenia.[85] Children are more susceptible to psychological harm from traumatic events than adults,[86] but their reaction does vary by individual child, age, the type of event, and the length of exposure.

Neglect is a form of mistreatment in which the responsible caretakers fail to provide the necessary age-appropriate care, supervision, and protection. It is different from abuse in that it is, in this context, not intentional in causing harms.[87] The long-term effects of neglect can be reduced physical, emotional, and mental health throughout the victim's life.[88][89]

Familial and close relationships

Parental divorce, death, absence, or the lack of stability appears to increase the risk of mental disorders in a child.[90] Early social privation, and the lack of "ongoing, harmonious, secure, committed" relationships have been implicated in the development of mental illnesses.[91] Continuous conflict with friends, one's support system, and family can all increase the risk of developing a mental illness or can worsen one's mental health.[92]

Divorce is a factor that affects adults as well as children. Divorcees may have emotional adjustment problems due to a loss of intimacy and social connections; however, new statistics show that the negative effects of divorce have been overstated.[93]

Social expectations and self-esteem

Having both too low or too high self-esteem can be detrimental to an individual's mental health.[94][95] Low self-esteem in particular can result in aggression, self-deprecating behavior, anxiety, and other mental disorders.[96] Being perceived as someone who does not "fit in" can result in bullying and other types of emotional abuse,[97][98] which can lead to the victim experiencing depression, anger, and loneliness.[99]

Poverty

Further information: Socioeconomic status and mental health and Social determinants of mental health
Poor Czech poor children in 1917.

Studies show that there is a direct correlation between poverty and mental illness: the lower the socioeconomic status of an individual, the higher the risk of mental illness. Impoverished people in England, defined as those who live in the lowest 20% income bracket, are two to three times more likely to develop mental illness than those of a higher economic class.[100] This increased risk remains consistent for all poor individuals regardless of any in-group demographic differences, as all disadvantaged families experience economic stressors such as unemployment or lack of housing. A lower or more insecure educational, occupational, economic, or social position is generally linked to more mental disorders.[101] Children from these backgrounds may have low levels of self-efficiency and self-worth.[102] Studies have also shown a strong relationship between poverty and substance abuse, another risk factor in the onset of mental disorders.[103]

Problems in one's community or culture including poverty, unemployment or underemployment, a lack of social cohesion, and migration have been associated with the development of mental disorders.[104] Personal resources, community factors, and interactions between individual and regional-level income levels have been implicated.[105] Socioeconomic deprivation in neighborhoods can cause worsen mental health, even after accounting for genetic factors.[106] According to a 2009 meta-analysis by Paul and Moser, countries with high income inequality and poor unemployment protections have worse mental health outcomes among the unemployed.[107]

The effects of different socioeconomic factors varies by country.

immigrants, are at a greater risk of developing mental disorders. This has been attributed to the insecurities in their lives and their disadvantages, including racism.[110] There have been alternate models, such as the drift hypothesis to account for the complex relationship between an individual's social status and mental health.[111]

Psychological and individual factors, including resilience

Some clinicians believe that psychological characteristics alone determine mental disorders. Others speculate that abnormal behavior can be explained by a mix of social and psychological factors. In many examples, environmental and psychological triggers complement one another resulting in emotional stress, which in turn activates a mental illness. Each person is unique in how they will react to psychological stressors. What may break one person may have little to no effect on another. Psychological stressors, which can trigger mental illness, are as follows: emotional, physical, or sexual abuse, loss of a significant loved one, neglect, and being unable to relate to others.[112]

The inability to relate to others is also known as emotional detachment. Emotional detachment makes it difficult for an individual to empathize with others or to share their feelings. These individuals tend to stress the importance of their independence and tend to struggle relating to others. An emotionally detached person may try to rationalize or apply logic to a situation to which there is no logical explanation. Often, the inability to relate to others stems from a traumatic event.

Mental characteristics of individuals, as assessed by both neurological and psychological studies, have been linked to the development and maintenance of mental disorders. This includes cognitive or

neurocognitive factors, such as the way a person perceives, thinks, or feels about certain things; or an individual's overall personality, temperament, or coping style
or the extent of protective factors or "positive illusions" such as optimism, personal control and a sense of meaning.

See also

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