Beyond Neurotransmitters: Integrating Biological, Structural, and Digital Determinants in Contemporary Psychiatry

Mental health disorders represent a leading cause of disability worldwide and require integrative frameworks that transcend traditional single-domain explanations. This review analyzes the neurobiological, social, and digital dimensions of psychiatric disorders through a structured synthesis of international literature. Neurobiological evidence highlights circuit-level dysfunction, stress-mediated neuroplasticity, inflammatory pathways, and gut–brain interactions as core vulnerability mechanisms. Social epidemiology research demonstrates that income gradients, structural inequality, and hierarchical stress responses shape population-level distribution of mental morbidity. Concurrently, digital environments function as both intervention platforms and behavioral risk modifiers, with smartphone-based tools showing therapeutic potential while excessive screen exposure and maladaptive social media engagement correlate with adverse outcomes. The findings support a multidimensional systems-based model in which biological substrates, structural determinants, and technological ecosystems interact dynamically. This framework holds particular relevance for middle-income contexts, including Mexico, Colombia, and Ecuador, where rapid digitalization coexists with socioeconomic disparities. Integrating these domains strengthens clinical reasoning, psychiatric education, and public health strategy design, promoting a comprehensive and ethically guided approach to contemporary mental health care.