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There are several well known factors which determine mental illness:

Infections -Syphilis, HIV

Trauma-post head injury

Neoplasms-Brain tumors may present with personality change and mental distress

Genetics-Huntington’s chorea and dementia

Vascular-post stroke or intermittent arterial embolism

Drug abuse-Korsakoff’s psychosis in chronic alcoholics

but often there is no obvious cause.