i feel you need to go with whatever explanations you are drawn to & that make sense to you. Nothing makes full sense to me in relation to it all, i can see some truth in all the different perspectives, & yet i don't have categorical answers. i see a mystery in madness.

For various reason i think the primary aetiology in the majority of cases is psychogenic, but that is my personal opinion.

Hope you don't mind a bit of debate - i think it's healthy.