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Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES


Sta. Mesa Manila
COLLEGE OF SOCIAL SCIENCE AND DEVELOPMENT
6th Floor, Main Academic Bldg., A. Mabini Campus, Anonas St.,
Sta. Mesa, Manila

Mental Illness
Is a
Biological Disease
Submitted by:
BS Psychology 3-1

Members:

Abello, Seandee
Dantes, Crisostomo Jr.
De Mesa, Honey Joy
Sarcia, John Carlo
Solitario, Franz Gian
Trinidad, Leizl
INTRODUCTION:
Mental illnesses are brain-based conditions that affect thinking, emotions, and behaviors. For
people who have mental illnesses, their brains have changed in a way in which they are unable to
think, feel, or act in ways they want to. For some, this means experiencing extreme and
unexpected changes in mood – like feeling sadder or more worried than normal. For others, it
means not being able to think clearly, not being able to communicate with someone who is
talking to them, or having bizarre thoughts to help explain weird feelings they are having. One
of the few questions people with a family member that has mental illness is “would they have the
same illness too?” Some mental illnesses have been linked to abnormal functioning of nerve cell
circuits or pathways that connect particular brain regions. Nerve cells within these brain circuits
communicate through chemicals called neurotransmitters. Neurotransmitters serve as a
communications system between nerve cells in the brain. If these chemicals are out of whack, or
working in a substandard manner, there will be an interruption in the brain as it attempts to
process incoming messages. The result is a display of the symptoms of mental illness. There are
also certain defects or brain injuries that have been linked to some mental illnesses. This means
mental illness could be biological.
Each year, nearly 1 in 5 American adults experiences mental illness. Of those adults, 14.4
percent have one disorder, 5.8 percent have two disorders and 6 percent have three or more. That
is 1 of 5 but it is equivalent to 43.8 million people already and that is in America only. Based on
the data from the Global Epidemiology on Kaplan and Sadock’s Synopsis of Psychiatry in 2015
and Kaufman’s Clinical Neurology for Psychiatrists in 2013, about a million Filipinos suffered
from schizophrenia, another million had bipolar disorder, while 17 million suffered from major
depressive disorder. In 2018, according to DOH, there is an estimated population of 108.12, at
least 19 million Filipinos suffer from schizophrenia, major depressive disorder, and are
considered bipolar. The largest group, accounting for 17 million, is composed of those who
suffer from major depressive disorder. While mental health issues awareness is slowly spreading
in the country. People would ask what could be the cause/s of this illness.
There are little data on prescription rates and the use of psychotropic medications in treating
mental disorders and a national Department of Health Medication Access Program for Mental
Health that carries a central list of essential medications. These medications are available at all
service levels, but funding issues limit patient access, particularly access to newer medications.
The most commonly used antipsychotics in clinical practice are chlorpromazine and haloperidol.
The sad thing is, while no one is spared from the possibility of suffering from mental illness,
mental health remains to be a misunderstood topic in the country.

OBJECTIVES:
 The researchers’ aim to assess the relationship between biological aspect and mental
health.
 To determine the biological causes of mental illness.
 To develop further knowledge in regards to biological disease and mental illness.
RESULTS AND DISCUSSION:
Since the beginning, scientists have worked overtime to find the biological factor/s responsible
for mental illnesses. Different factors were considered and actually rejected. Just as many factors
appeared, different terminologies were also used disease, illness, disorder. Just as scientists
clarified many topics regarding science, terminologies must also be used properly. Many people
have a misconception about the words disease, disorder and illness. People often take these
words as one but these words have a different meaning based on their field. In psychology,
disorder is defined as a disruption to the normal or regular function in the body or a part of the
body; while illness defined as a broad term that defines the poor state of mind, body, and to a
certain extent, spirit. On the other hand, disease is a result from a pathophysiological response to
external and internal factors. In fact, disease and disorder are under of illness’ umbrella.
In psychological field there are mental illnesses that are considered biological; such as,
schizophrenia, bipolar, autism, Attention Deficit Hyperactivity Disorder (ADHD), and Major
Depressive Disorder (MDD).
In the article, “Causes of Mental Health” biological factors have been pointed out as cause of
mental illness. Here are those:

1. Genetics (heredity) - Mental illnesses sometimes run in families, suggesting that people
who have a family member with a mental illness may be somewhat more likely to
develop one themselves. Susceptibility (genetic) is passed on in families through genes.
Experts believe that many mental illnesses are linked to abnormalities in many genes
rather than just one or a few and that how these genes interact with the environment is
unique for every person (even identical twins). That is why a person inherits a
susceptibility to a mental illness and doesn't necessarily develop the illness.

According to an article by Maia Szalavitz last Feb. 28, 2019 entitled Most Common
Psychiatric Disorders Share Genetic Roots and on Aug. 12, 2013 entitled Common
Genetic Ground Found for Depression, Schizophrenia, Autism; researchers analyzed
genetic data from some 33,000 people of European descent who had
either autism, schizophrenia, major depression, bipolar disorder or attention deficit/
hyperactivity disorder (ADHD). They were compared with nearly 28,000 unaffected
controls. Scanning the entire genome, the scientists found variants in four different
regions that affected risk for all or most of these conditions. The results suggest that it
may be possible to move away from classifying psychiatric disorders primarily based on
profiles of symptoms and focus on biological causes of mental illness, according to the
study’s lead author, Dr. Jordan Smoller of Massachusetts General Hospital. However,
expanding on results reported earlier that year from psychiatry’s largest ever experiment,
researchers now report that known genetic variations account for 17% to 29% of the risk
for schizophrenia, depression, bipolar disorder, autism and attention-deficit/hyperactivity
disorder (ADHD). And risk for one condition is often strongly linked with risk for others.
Mental illnesses like depression and schizophrenia clearly run in families, but
neuroscientists have always assumed that the biological drivers behind these disorders
were distinct. Studying gene-based differences among the patients and in people who did
not have mental illnesses, the scientists detailed with unprecedented precision how
groups of the same genetic mutations could be linked to different mental illnesses.
Bipolar disorder and schizophrenia were most highly correlated — a finding that jibes
with both earlier research and the fact that the conditions can sometimes be mistaken for
each other in the clinic. The latest data suggests that seemingly disparate symptoms —
patients with bipolar disorder experience extreme mood swings, while people with
schizophrenia often suffer from delusions and paranoia — may not necessarily derive
from different genes, but rather from different timing of exposures to risk factors, such as
toxins or infectious disease during pregnancy, or early life trauma.

2. Infections - Certain infections have been linked to brain damage and the development of
mental illness or the worsening of its symptoms. For example, a condition known as
pediatric autoimmune neuropsychiatric disorder (PANDA) associated with the
Streptococcus bacteria has been linked to the development of obsessive-compulsive
disorder and other mental illnesses in children.
Dr. Bhupesh Prusty, a doctor in University of Würzburg’s Department of Microbiology
led a research about the relationship of infections in developing mental illness, and in the
article Viruses can trigger psychiatric disorders, Prusty and his team suspected the human
herpesviruses HHV-6A and HHV-6B to play a key role in the genesis of psychiatric
disorders. So they studied two of the largest human brain biopsy cohorts from Stanley
Medical Research Institute (USA) and what they found confirmed their assumption: "We
were able to find active infection of HHV-6 predominantly within Purkinje cells of
human cerebellum in bipolar and major depressive disorder patients," Prusty sums up the
central result of their study. The results show for the first time that type HHV-6 viruses
are capable of infecting neurons and possibly causing cognitive disturbances leading to
mood disorder.
3. Brain defects or Injury - Defects in or injury to certain areas of the brain have also been
linked to some mental illnesses.

In the largest study linking brain injury to mental illness which was studied by Danish
scientists, led by Sonja Orlovska, MD, of the Psychiatric Centre Copenhagen; an article
was published entitled Head injury can cause mental illness. It is a national register study
based on all Danes born between 1977 and 2000 – totalling 1.4 million people – who
were followed up to 2010. 113,906 of them had been admitted to hospital with a head
injury. Four percent of these were subsequently diagnosed with a mental disorder. The
researchers looked at the following disorders: depression, schizophrenia, bipolar disorder
and so-called organic mental disorders (a form of decreased mental function due to a
medical or physical disease, rather than a psychiatric illness).
By comparing the injured people’s risk of developing the disorders with the rest of the
study population, they found that those with head injuries were:
 65 percent more likely to be diagnosed with schizophrenia.
 59 percent more likely to develop a depression.
 28 percent more likely to be diagnosed with bipolar disorder.
 439 percent more likely to suffer from organic mental disorders.
The greatest risk of developing a mental disorder is in the first year after suffering head
trauma, but even after 15 years there was a significantly increased risk.
4. Prenatal Damage - Some evidence suggests that a disruption of early fetal brain
development or trauma that occurs at the time of birth -- for example, loss of oxygen to
the brain -- may be a factor in the development of certain conditions, such as autism
spectrum disorder.
In the article, Prevention and Early Intervention in Mental Health- Prenatal Period to
Early Childhood, the author addressed that some common health issues during pregnancy
have been linked to a child’s future mental health. Studies suggest that the risk for
developing schizophrenia is three times greater in children whose mothers’ had the flu
during pregnancy. Other studies show children born to mothers with iron deficiencies are
four times as likely to develop schizophrenia. In terms of maternal mental health, high
levels of stress, anxiety, and depression during pregnancy have been linked to preterm
birth and low birth weight. In multiple large studies, maternal trauma has been associated
with higher rates of psychiatric disorders in the child, and its effect may actually be
underestimated due to reliance on hospital records of disorders.
As mention above, the researchers already named some mental disorders that were caused by
biological factors. Below are some Case Studies that can strengthen these works:
 Schizophrenia
Schizophrenia is a chronic recurring psychotic illness that characteristically begins in young
adult years and lasts a lifetime. The monozygotic twin of a person with schizophrenia, who
shares the same genome, has a 40% to 50% risk of contracting the illness; this number represents
not only a 50% genetic risk, but also a 50% non-genetic risk, each operating in the
manifestations of the illness. Association studies written in the article, The Biology of
Schizophrenia, suggest that schizophrenia is a complex multigenetic disorder. Many genes
associated with the illness have been identified in the different studies. Each risk factor confers a
small risk, with the genetic factors being the most potent. Risk factors are thought to be
multiplicative.
It says in the Clinician-Rated Assessment of Symptoms and Related Clinical Phenomena in
Psychosis Psychotic, sited from Diagnostic Statistical Manual of Mental Disorders (DSM V),
disorders are heterogeneous, and the severity of symptoms can predict important aspects of the
illness, such as the degree of cognitive or neurobiological deficits as well in the Risk and the
Prognostic Factors includes Genetic and Physiological, there is a strong contributions for genetic
factors to determining risk for schizophrenia, although most individuals who have been
diagnosed with schizophrenia have no family history of psychosis. Pregnancy and birth
complications with hypoxia (deficiency in the amount of oxygen reaching the tissues) and
greater paternal age are associated with a higher risk of schizophrenia for the developing fetus.

 Autism Spectrum Disorder


According to Michael j. Gertner, in his article The Biological Causes of Autism, the biological
causes of autism may appear to have a different implication for brain function and consequently,
treatment. Researchers have discovered that tuberous sclerosis -- a rare disease on the autism
spectrum – caused by too little protein synthesis within the synapses of the brain. Given the
complexity of autism risk, researchers have begun to investigate how pre- and post-natal
environmental factors like exposure to drugs and environmental toxicants might interact with
genetic susceptibility to ASD. A number of environmental exposures have been identified by
Landrigan, Lambertini, & Birnbaum, 2012; Shelton, Hertz-Picciotto, & Pessah, 2012 for future
study, including lead, polychlorinated biphenyls (PCBs), insecticides, automotive exhaust,
hydrocarbons, and flame retardants. However, no specific environmental triggers have been
identified at this time.
According to DSM V, under the section Risk and Prognostic Factors of Autism Spectrum,
heritability estimates for autism spectrum disorder have ranged from 37°/^ to higher than 90%,
based on twin concordance rates. Currently, as many as 15% of cases of autism spectrum
disorder appear to be associated with a known genetic mutation, with different de novo copy
number variants or de novo mutations in specific genes associated with the disorder in different
families. However, even when an autism spectrum disorder is associated with a known genetic
mutation, it does not appear to be fully penetrant. Risk for the remainder of cases appears to be
polygenic, with perhaps hundreds of genetic loci making relatively small contributions.

 ADHD (Attention Deficit Hyperactivity Disorder)


In the Italian Journal, The Neurobiological basis of ADHD, ADHD was first recognized 100
years ago as a childhood disorder found mainly in boys, and was initially described as
"hyperactivity" or "hyperkinetic disorder of childhood". This abnormal behavior was found to be
the result of a biological condition rather than a result of poor parenting. In the 1960's and 70's
much of the focus on what is now called ADHD was on hyperactivity. The presence of excessive
movements in children was proposed to result from bilateral cortical activity secondary to a lack
of transcallosalfibre tract-mediated interhemispheric inhibition. Also, the prefrontal cortex, basal
ganglia and cerebellum are differentially affected and evidence indicating reduced connectivity
in white matter tracts in key brain areas is emerging. Genetic, pharmacological, imaging, and
animal models highlight the important role of dopamine dysregulation in the neurobiology of
Attention-Deficit/Hyperactivity Disorder.
In DSM V under the section Risk and Prognostic Factors of ADHD, ADHD is elevated in the
first-degree biological relatives of individuals with ADHD. The heritability of ADHD is
substantial. While specific genes have been correlated with ADHD, they are neither necessary
nor sufficient causal factors. Visual and hearing impairments, metabolic abnormalities, sleep
disorders, nutritional deficiencies, and epilepsy should be considered as possible influences on
ADHD symptoms. ADHD is not associated with specific physical features, although rates of
minor physical anomalies (e.g., hypertelorism, highly arched palate, low-set ears) may be
relatively elevated. Subtle motor delays and other neurological soft signs may occur.

 Major Depressive Disorder


In a medical web article entitled, Causes of Depression, the researchers have noted differences in
the brains of people who have a clinical depression as compared to those who do not. For
instance, the hippocampus, a small part of the brain that is vital to the storage of memories,
appears to be smaller in some people with a history of depression than in those who've never
been depressed. A smaller hippocampus has fewer serotonin receptors. Serotonin is one of many
brain chemicals known as neurotransmitters that allow communication across circuits that
connect different brain regions involved in processing emotions.
In an article published and posted (2009) in Harvard Health Publishing last updated on June, 24
2019, Depression doesn't spring from simply having too much or too little of certain brain
chemicals. Rather, there are many possible causes of depression, including faulty mood
regulation by the brain, genetic vulnerability, stressful life events, medications, and medical
problems. It's believed that several of these forces interact to bring on depression.
According to DSM V Section Risk and Prognostic Factors of ADHD, first-degree family
members of individuals with major depressive disorder have a risk for major depressive disorder
two- to fourfold higher than that of the general population. Relative risks appear to be higher for
early-onset and re- current forms. Heritability is approximately 40%, and the personality trait
neuroticism ac- counts for a substantial portion of this genetic liability.

 Bipolar Disorder
One of the World Journal – The underlying neurobiology of bipolar disorder, states that the
stimulus for the study of the biogenic amines in patients with bipolar disorder was provided by
the discovery of effective pharmacologic treatments for depression and mania. In addition to
these compelling pharmacological data, the biogenic amine neurotransmitter systems are
distributed extensively in the limbic system, which is implicated in the regulation of sleep,
appetite, arousal, sexual function, endocrine function, and emotional states such as fear and rage.
The clinical picture of bipolar disorder involves disruption of behavior, circadian rhythms,
neurophysiology of sleep, neuroendocrine and biochemical regulation within the brain. These
complex illness manifestations are undoubtedly mediated by a network of interconnected
neurotransmitter pathways; the monoamine neurotransmitter systems are ideally placed to
mediate such complex behavioral effects, and thus represent attractive candidate systems
underlying the pathophysiology of bipolar disorder.
According to DSM V under the section Risk and Prognostic Factors of ADHD, Genetic and
Physiological, a family history of bipolar disorder is one of the strongest and most consistent risk
factors for bipolar disorders. There is an average 10-fold increased risk among adult relatives of
individuals with bipolar I and bipolar II disorders. Magnitude of risk increases with degree of
kinship. Schizophrenia and bipolar disorder likely share a genetic origin, reflected in familial co-
aggregation of schizophrenia and bipolar disorder.
Unlike some disease diagnoses, doctors can't do a blood test or culture some microorganisms to
determine whether a person has a mental illness. Mental health professionals will have to
diagnose mental illnesses based on the symptoms that a person has. And while doing so, factors
that put individuals at risk should be identified. Most mental disorders are caused by a
combination of multiple genetic, environmental and social factors. In fact, all these factors most
likely combine to influence whether someone becomes mentally ill.

CONCLUSION:
Mental illness is a sublevel of psychological disorder. Tracing the causes of mental illness is a
much more difficult task than locating structural damage in the brain. Psychiatric illnesses are
disturbances of higher mental function. Mental illness itself occurs from the interaction of
multiple genes and other factors -- such as stress, abuse, or a traumatic event -- which can
influence, or trigger, an illness in a person who has an inherited susceptibility to it. As far as
mental illness is concern, the above articles with the help of DSM V have provided us insights
and best explain the contribution of the three (3) factors in mental illness- biological,
environmental and social factors.
Furthermore, although most mental illnesses have an important genetic component, they do not
have straightforward inheritance patterns, because they are not caused by mutations of a single
gene. Thus, there is no single gene for schizophrenia, just as there is no single gene for anxiety
disorders, depression, or most other mental illnesses. Instead, the genetic components of these
diseases are thought to arise from interaction with the environment of several genes, each of
which exerts a relatively small effect. Together, the several genes create a genetic predisposition
— a potential — for a disorder. Most psychiatric disorders are caused by a combination of these
genetic predispositions and some additional, environmental factors.
All these factors should be considered to agree that a person is mentally ill. Without the other
factors, no studies yet that could prove that mental illness is purely a biological disease.

REFERRENCES:
National Mental Health Program of DOH https://www.doh.gov.ph/national-mental-health-
program
5 Surprising Mental Health Statistics https://www.mentalhealthfirstaid.org/2019/02/5-surprising-
mental-health-statistics/
PHL confronts costs, effects of issues on mental health
https://businessmirror.com.ph/2019/09/05/phl-confronts-costs-effects-of-issues-on-mental-
health/?fbclid=IwAR1pgvWjXImkB3H9Sfi9oJIot0CEj6FzgjgSbA3_9sxK43KbCnHdxuzOGrQ
Mental Illness And The Family: Recognizing Warning Signs And How To Cope
https://www.mhanational.org/recognizing-warning-signs
Causes of Mental Illness https://www.webmd.com/mental-health/mental-health-causes-mental-
illness#1
Disease versus illness in general practice
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1972172/
Common Genetic Ground Found for Depression, Schizophrenia, Autism
http://healthland.time.com/2013/08/12/common-genetic-ground-found-for-depression-
schizophrenia-autism/
Most Common Psychiatric Disorders Share Genetic Roots
http://healthland.time.com/2013/02/28/most-common-psychiatric-disorders-share-genetic-roots/
Viruses can trigger psychiatric disorders, research suggests
https://www.sciencedaily.com/releases/2018/08/180809112440.htm
Head injury can cause mental illness https://sciencenordic.com/biology-denmark-
depression/head-injury-can-cause-mental-illness/1395035
Prevention And Early Intervention In Mental Health- Prenatal Period To Early Childhood
https://www.mhanational.org/issues/prevention-and-early-intervention-mental-health-prenatal-
period-early-childhood
The biology of schizophrenia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181617/#__sec16title
The Biological Causes of Autism https://www.theatlantic.com/health/archive/2011/12/the-
biological-causes-of-autism/249550/
The neurobiological basis of ADHD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016271/
Causes of Depression https://www.webmd.com/depression/guide/causes-depression#2
The underlying neurobiology of bipolar disorder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525098/
Inheriting Mental Disorders https://www.healthychildren.org/English/health-
issues/conditions/emotional-problems/Pages/Inheriting-Mental-Disorders.aspx
BIOLOGICAL MARKERS FOR MENTAL ILLNESS https://www.edge.org/response-
detail/11436
Diagnostic Statistical Manual of Mental Disorders (DSM V)
Autism https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935303&section=Causes
What causes depression? https://www.health.harvard.edu/mind-and-mood/what-causes-
depression