ETIOLOGICAL FACTORS OF MENTAL ILLNESS

There are many factors responsible for the causation of mental illness. There is no single factor that contributes to mental illness.

Complications in the Study of Causation

In psychiatry, the study of the causation of mental illness is complicated because:

1. Causes are often remote in time from the effects that they produce.

2. A single cause may lead to several effects.

3. Etiological factors rarely exert their effects directly.

The causes are classified into three categories: Predisposing, Precipitating, and Maintaining factors.

A. PREDISPOSING FACTORS (INTRINSIC FACTORS)

These factors operate from early life or are factors people are born with, determining their vulnerability to mental illness. They interact with precipitating factors, resulting in mental illness.

• Heredity: Genetic endowment or factors that run in the family because of the presence of the genes of that illness. Many studies suggest that psychotic individuals owe their condition mainly to unfavorable heredity.

• Environment in the uterus: This includes factors such as maternal infections, or the use of drugs or substances before delivery.

• Biochemical factors: Abnormal neurotransmitters in the brain are considered the cause of some psychological disorders. Examples include dopamine, acetylcholine, serotonin, adrenaline, and noradrenalin.

• Personality: Some specific personality types are more prone to developing certain psychological disorders. Examples include people who are schizoid, antisocial, hysterical, ambitious, or cyclothymic.

B. PRECIPITATING FACTORS

These are factors that occur shortly before the onset of a disorder and appear to have induced the disorder. They usually act close to the time of the illness.

I. Psychological and Social Factors

These factors are often caused by the parents and can affect the child at a later stage. Faulty upbringing is the act of raising a child in a harmful way.

• Faulty Upbringing:

  • Maternal deprivation: Lack of maternal love, emotional warmth, affection, and security.

  • Overprotection: Not allowing a child to experience or face challenges.

  • Anxious parents: Parents who expect too much over a short period from their children. Children are usually heavily punished when mistakes are made and ignored when they do well.

  • Childhood insecurities due to death or separation of parents.

II. Psychological Stresses

• Psychological problems such as at work or home.

• Financial problems.

• Loss of job.

• Disappointment.

• Loss of status or position in society.

• Failure to achieve goals.

III. Marriage and Partnership

• Failure to marry.

• Infertility.

• Divorce or separation.

• Unwanted sex.

• Domestic violence and misunderstanding in a home/disharmony.

IV. Social Factors

• Poverty or unemployment.

• Insecurity or disasters.

• Very big family; failure to feed or accommodate the members.

V. Physical Stresses

• Physiological changes such as in puberty, adolescence, etc.

• Infections for example malaria, meningitis, HIV/AIDS.

• Drugs: Alcohol, khat, marijuana, heroin, pethidine, cocaine cause abnormal behavior changes in individuals who abuse the substance.

• Tumor of the brain.

• Changes in brain function for example changes in blood glucose level, fluid and electrolyte imbalance, etc.

• Trauma to the brain for example in a road traffic accident.

• Metabolic deficiencies especially vitamin deficiencies.

• Degenerative conditions such as dementia.

• Poisons or intoxication.

• Vascular factor such as severe hemorrhage.

• Chronic illnesses for example diabetes, tuberculosis, hypertension, etc.

C. MAINTAINING OR PERPETUATING FACTORS

These factors prolong the course of the disorder after it has been provoked, or they aggravate the disease already existing. They include:

• Lack of support from the family or relatives.

• Use of alcohol or substance when already sick.

• Difficult personality (e.g., aggressive, isolated, timid, etc.).

• Family problems (for example domestic violence).

• When a patient is institutionalized or dependent on others.