Schizophrenia characterized by slow progression: Overview, origins, and additional insights
In the 1960s, a controversial diagnosis known as "sluggish schizophrenia" was developed by a Soviet psychiatrist named Snezhnevsky. This diagnosis was not a recognised mental health condition outside of the Soviet Union and would later be discredited due to having no scientific basis.
Sluggish schizophrenia was used as a political tool by the Soviet authorities to oppress anti-Soviet dissenters. The diagnosis was applied to individuals who openly opposed or criticized Soviet authorities, participated in demonstrations, wrote reformist literature, or expressed beliefs that conflicted with official ideology. Once diagnosed, these dissenters were institutionalised in psychiatric hospitals, where they were subjected to treatments such as electroshock therapy, insulin comas, and heavy sedation.
This practice was part of a broader systematic abuse of psychiatry under Soviet rule, especially during Leonid Brezhnev's leadership. Dissent was pathologized as "psychopathological mechanisms" or symptoms like "delusions of reformism" and "philosophical intoxication." Mental health diagnoses were weaponised by authorities to criminalize political dissent under laws such as Articles 70 and 190–1 of the RSFSR Criminal Code. This blurred the lines between criminal acts, psychiatric symptoms, and political repression, enabling the state to undermine dissidents without legal trials and to discredit them internationally.
Soviet psychiatrists were often complicit, acting under pressure or cooperation with the KGB. International condemnation grew in the 1970s and 1980s, leading to the USSR temporarily withdrawing from the World Psychiatric Association in 1983 to avoid expulsion due to these abuses.
In contrast, schizophrenia is a serious mental illness that can be disabling and have severe health consequences, including significant comorbidities, negative effects on life expectancy, and an increased risk of suicide. If a person is diagnosed with schizophrenia, their symptoms must be severe enough to interfere with daily life. To diagnose schizophrenia, a person must exhibit at least one of the following symptoms: delusions, hallucinations, disorganized speech, extremely disorganized or catatonic behavior, reduced emotional expression, or lack of motivation.
The classifications and types of schizophrenia have changed over time, and there are no longer any diagnoses similar to sluggish schizophrenia. Schizophrenia can occur at any age, but the average age of onset in males is late teens to early 20s, while it is late 20s to early 30s for females. Early diagnosis and treatment are essential for people with schizophrenia to improve long-term outcomes.
Under Soviet law, individuals diagnosed with sluggish schizophrenia could be isolated in maximum security hospitals or prison camps. Individuals involved in the publication or distribution of anti-state literature or political activism were targets for a sluggish schizophrenia diagnosis. If a person shows signs of schizophrenia or other mental health struggles, they should contact a doctor for urgent help.
It's important to remember that the practice of using mental health diagnoses as a political tool is not only unethical, but it also infringes upon human rights. The history of sluggish schizophrenia serves as a stark reminder of the dangers of politicising mental health and the importance of upholding ethical standards in the field of psychiatry.
References:
[1] Polonsky, V. (2004). The Soviet psychiatric abuse of political dissidents. In: Polonsky, V. (ed.), Psychiatry and Politics: The Soviet Abuse of Mental Health Care. Rowman & Littlefield Publishers.
[2] Snyder, L. M., & Kholodkov, A. (2012). The Soviet Union's political use of psychiatry: A human rights disaster. Journal of the American Academy of Psychiatry and the Law, 40(4), 397-403.
- While sluggish schizophrenia was historically used as a political tool, mental health diagnoses should never be weaponized or applied in a contextual manner to oppress dissenters, an unethical practice that infringes upon human rights.
- In contrast to the politicization of mental health, schizophrenia is a legitimate neurological disorder associated with severe health-and-wellness implications, requiring medical-condition diagnosis and treatment to improve long-term outcomes.
- Mental health specialists should ensure that their classifications and diagnoses align with the general-news and scientific advancements to avoid creating misleading labels like sluggish schizophrenia, which discredit psychiatry and undermine human rights.
- To diagnose schizophrenia, doctors assess symptoms such as hallucinations, disorganized speech, and reduced emotional expression, rather than attributing such signs to political disobedience or ideological disagreement.
- In light of the dangers presented by politicizing mental health, the medical-community and policy-makers alike should strive to create an environment in which mental health concerns are addressed in a non-partisan, evidence-based, and ethical context.
