Causes of Mental Illness – Biopsychosocial Model

According to Dr. Kenneth Kalinaki from the Ministry of Health Uganda, the causes of mental illness can be investigated with the biopsychosocial model which states that the workings of the body, mind, and environment all affect each other. According to this model, none of these factors in isolation is sufficient to lead definitively to health or illness—it is the deep interrelation of all three components that leads to a given outcome.

This blog as one of the series I am writing about mental illness as a way to create awareness about mental health has details of how this comes about and diagnosis for the different common mental illnesses.

The factors mentioned are seen in the diagram below as Biological, Psychological, and Social.

These are investigated as contributors in different ways like clinical assessment and physical examination in making a psychiatric diagnosis.

For the Biological ones, all real diagnostic tests are done in psychiatry:

• Routine assessment of physical health
• Possible cause of psychiatric presentation.
• Assessment for any biological alteration.
• Assessment of drug adverse effects
• Dose monitoring

While the Psychological one needs psychiatric illness diagnoses done like

• Screening for psychiatric illness
• Confirm psychiatric diagnosis
• Follow up

Like for Depression, the tools used to investigate include

1. Beck Depression Inventory
2. Patient Health Questionnaire
3. Center for Epidemiological Studies Depression Scale
4. General Health Questionnaire.
5. Geriatric Depression Scale
6. Hamilton Depression Rating Scale
7. Zung Depression Self-Rating Scale

Then Psychosis is

1. Positive and Negative Syndrome Scale (PANSS)
2. Brief Psychiatric Rating Scale (BPRS)
3. Scale for the Assessment of Negative Symptoms (SANS)
4. Scale for the Assessment of Positive Symptoms (SAPS)

For Anxiety disorders which are very common the tools are

1. Hamilton anxiety scale
2. Beck’s anxiety scale
3. Generalized Anxiety D/o Questionnaire- IV
4. Social Phobia Inventory (SPIN)
5. Hospital Anxiety and Depression Scale
6. GAD-7

Bipolar /Mania is mainly

1. Manic state rating scale
2. Young Mania Rating Scale

Suicide

1. Suicide intent scale-SADPERSONS
2. Columbia-Suicide Severity Rating Scale (C-SSRS)

Drug and Substance Use

1. AUDIT
2. CAGE
3. AUDIT-C
4. DAST
5. ASSIST
6. ASI

Personality disorders

1. Minnesota multiphasic personality inventory
2. Cattels 16 factors personality inventory
3. Eysneck personality inventory

Cognitive Function

1. Wechsler adult intelligence scale
2. Wechsler intelligence scale for children
3. Stanford Binet test of intelligence
4. MMSE

And finally the Social investigations

• Collateral history from family, friends, school
• Home visits uschool visits
• Social adjustment scale uMarital satisfaction inventory