1950—1989PART G

Psychiatry as an instrument of the state

Soviet punitive psychiatry is the clearest documented case of diagnosis used politically. It is also the topic where the most inflated numbers circulate.

PEER-REVIEWED "SLUGGISH SCHIZOPHRENIA"
MOSCOW SCHOOL · SERBSKY INSTITUTE

A diagnosis elastic enough to hold dissent

In the Soviet Union, the diagnostic category "sluggish schizophrenia" — systematised in the 1950s and 1960s by Andrei Snezhnevsky's Moscow school from earlier concepts including Eugen Bleuler's "latent schizophrenia" — was drawn broadly enough that features such as a "delusion of reformism" or a "heightened sense of self-esteem" could be offered in support of a schizophrenia diagnosis.

The category was applied overwhelmingly to ordinary patients. But its elasticity made political misuse possible and left it unchecked. The Serbsky Institute in Moscow was the leading institution conducting forensic psychiatric examination of dissidents.

The official 1989 US delegation put it this way: "Some of the symptoms incorporated into Soviet diagnostic criteria for mild ('sluggish') schizophrenia are not accepted as evidence of psychopathology in the U.S. or under international diagnostic criteria."

[45] Bonnie RJ, J Am Acad Psychiatry Law 2002;30(1):136-144, quoting the 1989 US delegation report verbatim

PEER-REVIEWED WORLD PSYCHIATRIC ASSOCIATION
WITHDRAWAL JAN. 1983
READMISSION ATHENS, OCT. 1989

It withdrew before it could be expelled — and returned in Athens

The All-Union Society of Neuropathologists and Psychiatrists withdrew from the World Psychiatric Association in January 1983, citing a "slanderous campaign". Western participants in the campaign against Soviet psychiatric abuse — Sidney Bloch and Helsinki Watch, both writing in 1990 — state that the withdrawal pre-empted an expulsion vote.

The Society was readmitted at the WPA's Eighth World Congress in Athens on 17 October 1989, by 291 votes to 45 with 19 abstentions, on terms the resolution called "full membership with conditions": a Review Committee site visit within one year, and a special General Assembly to consider suspension if political abuse were found to continue.

We declare the gap: the WPA's own General Assembly records were not obtained for this account. The figures come from two independently published 1990 sources.

[46] Bloch S. "Athens and beyond: Soviet psychiatric abuse and the World Psychiatric Association", Psychiatric Bulletin 1990;14(3):129-133 · [47] Helsinki Watch, "The Legacy of Psychiatric Abuse in the USSR", May 1990

PEER-REVIEWED US DELEGATION
1989 · 27 EXAMINATIONS

Fourteen of twenty-seven — and what that does not mean

The 1989 US delegation examined 27 people whose names had been supplied by human rights organisations, the US Helsinki Commission and the State Department — cases referred because abuse was already suspected. It was not a random sample of Soviet patients.

US psychiatrists found 14 of the 27 to have no mental disorder: 5 of the 15 then hospitalised, and 9 of the 12 already released. Soviet psychiatrists examining the same people concurrently also found no current evidence of schizophrenia in those 14.

The distinction that changes the meaning: among those actually hospitalised — the population the phrase "no disorder justifying hospitalisation" points at — the finding was 5 of 15. A third, not a majority. The claim that "most people in Soviet psychiatric hospitals were well" is not supported by the delegation's own breakdown.

[45] Bonnie RJ, J Am Acad Psychiatry Law 2002;30(1):136-144 · [58] van Voren R, Schizophr Bull 2010;36(1):33-35

Psychiatry as an instrument of the state

A diagnosis elastic enough to hold dissent

It withdrew before it could be expelled — and returned in Athens

Fourteen of twenty-seven — and what that does not mean

Sources for this section