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It's long been known Vincent van Gogh had issues: He sliced off his ear during an 1888 breakdown, which was followed by his apparent suicide in 1890.

Now a group of experts has concluded the Dutch artist was plagued by short psychotic episodes during his last 18 months of life, the BBC reports.

But while those episodes may have been caused by medical conditions such as bipolar disorder, schizophrenia, or syphilis, all of which were scrutinized by the researchers, the panel is leaning more toward everyday stresses as pushing him over the edge, per the Telegraph.

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"Before December 23, 1888, it is not really possible to say he had a disease or an illness," says Arko Oderwald, the moderator of the Amsterdam scientific gathering.

And per a University of Amsterdam art history professor who spoke with the New York Times, it was a "fierce" debate among the three dozen or so international mental health professionals, medical doctors, and art historians who tried to figure out van Gogh's deal.

The Kokomo Herald reports the attacks in van Gogh's final years included "terrifying hallucinations," vertigo, unconsciousness, and amnesia. The group examined materials the Van Gogh Museum had gathered, including personal letters, medical records, and other data.

Says Oderwald, the psychosis "could [have] come from alcohol intoxication, lack of sleep, work stress and troubles with [roommate Paul] Gauguin, who was going to leave." (A 1930 sketch may reveal the truth of van Gogh's mutilated ear.)

This article originally appeared on Newser: Experts Chip Away at Mystery of van Gogh's Breakdowns