Russian Psychiatry Research Articles

« Ils me versent de l’eau froide sur la tête » : Corps et folie à l’époque romantique

This article describes the place of the body in Russian psychiatry of the 1830s , and places it at the intersection of philosophy , theology and medicine . We show how contemporary literature quotes and distorts medical discourse and develops its own conception of the body . Denied , annihilated , bruised , mutilated , deprived of food , the bodies of madmen seem to be victims of the violence that these madmen impose on themselves . In our conclusion , we question the place of the voice of madmen in the literary text , arguing that this voice is at times the expression of the silent body , and at other times the expression of the souls that transcend these very bodies.

Forensic psychiatry in Russia - the links with Britain evolve further

The perception of forensic psychiatry in Russia has been affected by the abuse of psychiatry for the detention of political dissidents during the later Soviet period ([Smith & Oleszczuk, 1996][1]). The Royal College of Psychiatrists played a key role in sanctioning the Soviet Society of

Общественная психиатрия — возрождение наследия земских психиатров

The purpose of the study : to analyze the reforms of the Russian psychiatry beginning in the zemsky period of public administration, to establish the role in these reforms of public psychiatrists, to determine the purpose and objectives of the special direction of scientific and practical psychiatry called «public psychiatry». Materials and methods : the material for this work was a set of scientific publications on the problems of formation of mental health care in its various historical periods. The analysis of materials is based on the methodology of qualitative research. Results : the analysis of the evolutionary development of the direction of «Public psychiatry» in the period of Zemsky and Soviet psychiatry, as well as in the post-Soviet period. The assessment of the role of public organizations of users of psychiatric care in the new Russia, which are considered as an important additional link of the state system of psychiatric care. Conclusion : is supposed important to use the traditions of the zemsky psychiatry for the further development of public psychiatry.

The evolution of psychiatry in Russia

The history of Russian psychiatry goes back many centuries. Since time immemorial, insane people in Russia lived in monasteries. In 1760, two special asylums were opened. The year 1824 saw the open...

Latent and simple forms of schizophrenia in the concept of E. Bleuler

E. Bleuler's concept of latent schizophrenia, its relationship with the form of simple schizophrenia and the foundation of the idea that each form of schizophrenia can be latent are analyzed. Bleuler's interpretation of the meaning of different psychopathological symptoms for the diagnosis of schizophrenia and some innate contradictions of his diagnostic approach (declared criteria of absoluteness) are discussed. Different influences of Bleuler's concept on the following national concepts of schizophrenia and its development in the Russian psychiatry are noted.

The presumption of mental health: is it really proved?

The article is devoted to one of the most complicated and peculiar problems of modern psychiatry - the presumption of mental health. Its originality is seen in the fact that practically all speaking and writing about it noted the importance of this principle for the protection of rights and legal interests of citizens, failing into the field of psychiatry. However, expressing this opinion, doctors and lawyers offer very few arguments in support of this view. Traditional arguments in favor of the presumption of mental health, scattered and unsystematic, prove to be absolutely insolvent. It was also found out that the similarity of the presumption of mental health with the presumption of innocence is capable to entail negative consequences. The noted similarity strengthens stigmatizing effect of psychiatric diagnosis, making it extremely undesirable for the patient, and the basis of the relationship between the patient and the doctor laid counterproductive antagonistic model as the model of mutual relations of the accused with the prosecutor. The main conclusion of authors is that the supporters of the presumption of mental health have yet to prove its right to exist, to work out its content and try to neutralize some of the negative consequences of its possible implementation in practice. Without compliance with the listed conditions to bring the presumption of mental health to the level of one of the fundamental principles of Russian psychiatry would be premature.

La psychiatrie en Moldavie, le parcours d’une psychiatrie totalitaire vers une psychiatrie communautaire

ObjectivesThis article describes the development of psychiatric care in the present territory of the Republic of Moldova, which was formerly a part of the Moldavian Principality, and then a Russian province from 1812 to 1918. Afterwards, it belonged to Romania, before becoming a Soviet republic from 1940 to 1991 when it became an independent country. MethodsA longitudinal, retrospective analysis, using empirical methods and comparisons of bibliographic and statistical data, documents, activity reports, and evidence, enabled a synthesis and the description of the evolution of psychiatric care in Moldova. ResultsBy way of this analysis, we have delineated the different stages in the development of psychiatry in Moldova. In the Middle Ages, after the establishment of the Moldavian Principality, there was a humanist attitude towards mental patients. The Christian church, which often had the charge of these patients, was tolerant and protective towards them. The second stage started after the annexation of Moldova to the Russian Empire in 1812, the establishment of the first beds in general hospitals, and the opening of the first psychiatric hospital in 1895, which became at the time one of the most progressive and modern among the psychiatric hospitals of Russia, with the shortest duration of hospitalisation, and a large number of rehabilitation measures entailing work projects, patient colonies, and life in the community. This tendency persisted during the Romanian period, when the territory retrieved its cultural and linguistic links, making visible progress in the treatment of patients in the area of malnutrition (pellagra), and achieving a considerable reduction in the number of patients with pellagra. The Soviet period saw contradictory trends. On the one hand, the considerable development of hospital care, as a result of the establishment of new hospital centres, adequate drug supplies and the availability of rehabilitation care. At the same time, there was a considerable broadening of the criteria for schizophrenia diagnosis, which could serve as grounds for coercive hospitalisation. Individuals who displayed paranoid, borderline, schizoid manifestations were hospitalised with a diagnosis of mild schizophrenia, which meant compulsory treatment. In addition to this, far-reaching rehabilitation provisions were developed for the patients. The current period is characterised by a wide receptiveness in society towards psychiatric patients, a significant reduction in inpatients beds and the opening of centres in the community. At the same time, there is a considerable shortage of last-generation drugs which are not available for the majority of the population. A medical insurance system has been in place for several years and patients can receive basic care. DiscussionThe development of psychiatric care in the present territory of the Republic of Moldova over one century, from the tsarist regime to Romanian capitalism, then to the Soviet system and finally the independent State with European aspirations, has seen significant changes and enriching experiences at all stages and under all regimes. The foundations of the modern Moldavian psychiatry were laid by Russian psychiatry which followed on from the German psychiatric school. At present, the main concerns are related to future development and to the reorganisation of mental health, with particular emphasis on outpatient care and rehabilitation. The main problems to be overcome are the stigmatisation and discrimination of psychic patients, and the need for social structures in a very difficult economic and demographic context. Despite this situation, a mental health reform project is being implemented in the country over the period 2015-2018 by Trimbos Institute (the Netherlands Institute of Mental Health and Addiction), financed by the Swiss Government. The aim of the project is to develop a community mental health model so as to considerably reduce the number of beds in psychiatric hospitals. ConclusionThis work provides a retrospective account of psychiatric care in the present territory of the Republic of Moldova, and describes the current situation of the mental health system which is undergoing a process of fundamental change modelled on community psychiatry, despite the very difficult financial situation.

The Limits for Deinstitutionalization of Psychiatry in Russia: Perspectives of Professionals Working in Outpatient Mental Health Services

:The purpose of this study was to explore the views of mental health professionals on deinstitutionalization reforms in Russia. Qualitative interviews were conducted with 33 specialists from outpatient mental health clinics. The data were analyzed using thematic analysis. The results revealed that the professionals appeared very restrained in supporting the reforms. They argued for the preservation of the existing mental health care system rather than its transformation. Their lines of argumentation were organized around four key themes as follows: 1) critiques of state policies and a suspicion of reforms, 2) tradition instead of innovation: reclaiming the image of Soviet psychiatry, 3) hospitals as a means of social control, and 4) reform as a threat to the protection of people with mental health problems. The findings suggest that practitioner resistance to deinstitutionalization is a complex phenomenon, demonstrating how various political, economic, social, and cultural factors are intertwined in the construction of professional discourse on the reforms.

A role of Russian psychiatrists in the formation of forensic psychiatry in Russia in the beginning of XIX century

The formation of forensic psychiatry knowledge as a special area of concern was due to fundamental changes in the social, economic and political life of Russia society. It reflected public awareness of the urgent need in solving the problem of support, preserve and maintain the mental health of the people. Forensic psychiatry was based on the development of psychiatry, public health and community medicine. Author describes of the role of Russian psychiatrists in the formation of forensic psychiatry, their active particitpation in internation professional meetings and in the development of the problem of responsibility.

P.A. Butkovsky - the founder of Russian psychiatry

P.A. Butkovsky - the founder of Russian psychiatry

The First World War and the development of Russian psychiatry

The First World War and the development of Russian psychiatry

The fate of Polish psychiatry under German occupation during World War II

Polish psychiatry was since its origin deeply influenced by German (Austrian) and Russian psychiatry. After the German assault Polish psychiatric patients were the first victims of mass executions, and the first to be killed by new developed "gassing" technology. Especially cruel was the fate of Jewish patients. German "health policy" in occupied Poland was only "starvation or shooting". Some hospitals continued working under German rule and received patients from Germany in the framework of Nazi-"euthanasia". The article describes the mostly ignored facts of the close link between the medical programme of annihilation of the "unfit" and the genocide of Poles and Jews.

Psychiatry in Russia

SummaryRussian psychiatry has dramatic history, and till now is at a transitional stage of development. It is facing the problems not only common in world psychiatry, but also specific for the Eastern Europe, in particular for Russia. Starting from the beginning of 1990s considerable changes have occurred in psychiatry, especially after 1992 when “The law on psychiatric care and guarantees of citizens rights in its provision was adopted”. It became the ideological and legislative basis for reforms. However there are the definite obstacles for structural reforms in psychiatry. They are as follows: unfavourable technical conditions in many psychiatric clinics, hypercentralization of psychiatric services, shortage of clinical psychologists and social workers in psychiatry, some difficulties in cooperation between psychiatric and general medical institutions. Economic difficulties of the transition period of Russia’s social development prevent overcoming these problem. They are being actively discussed and part of them is being gradually solved, e.g. organization of team work in mental health services, increasing number of specialists on social work, involvement of NGO’s in psychosocial rehabilitation.

Russian and Soviet forensic psychiatry: Troubled and troubling

Russian forensic psychiatry is defined by its troubled and troubling relationship to an unstable state, a state that was not a continuous entity during the modern era. From the mid-nineteenth century, Russia as a nation-state struggled to reform, collapsed, re-constituted itself in a bloody civil war, metastasized into a violent “totalitarian” regime, reformed and stagnated under “mature socialism” and then embraced capitalism and “managed democracy” at the end of the twentieth century. These upheavals had indelible effects on policing and the administration of justice, and on psychiatry's relationship with them. In Russia, physicians specializing in medicine of the mind had to cope with rapid and radical changes of legal and institutional forms, and sometimes, of the state itself. Despite this challenging environment, psychiatrists showed themselves to be active professionals seeking to guide the transformations that inevitably touched their work. In the second half of the nineteenth century debates about the role of psychiatry in criminal justice took place against a backdrop of increasingly alarming terrorist activity, and call for revolution. While German influence, with its preference for hereditarianism, was strong, Russian psychiatry was inclined toward social and environmental explanations of crime. When revolution came in 1917, the new communist regime quickly institutionalized forensic psychiatry. In the aftermath of revolution, the institutionalization of forensic psychiatry “advanced” with each turn of the state's transformation, with profound consequences for practitioners' independence and ethical probity. The abuses of Soviet psychiatry under Stalin and more intensively after his death in the 1960s–80s remain under-researched and key archives are still classified. The return to democracy since the late 1980s has seen mixed results for fresh attempts to reform both the justice system and forensic psychiatric practice.

1481 – New standards in schizophrenia outcomes : definition of therapeutic remission in russia before and after the international consensus-based remission criteria

In Russian psychiatry the definition of therapeutic remission includes an interval from full recovery (symptomatic and functional) to marked deficit and can be divided on different clinical types according to leading psychopathology. A standardized concept of remission in schizophrenia, based on dimensional approach, has been proposed (low symptom threshold in the eight core Positive and Negative Syndrome Scale symptoms for at least 6 consecutive months). Recent studies devoted to validation of the international criteria found several limitations. Analysis of limitations and combination of categorical and dimensional approaches allowed developing new standardized clinic- functional criteria of remission within two consecutive studies (1. population study of remission rate with 6-months follow-up period of symptomatic stability in two health care districts of an outpatient service (Moscow); 2. pharmacotherapeutic study in natural routine setting). New criteria of therapeutic remission are based on PANSS and PSP scales providing specific symptom and symptomatic threshold according to ICD-10 diagnosis and contain 8 symptoms of international criteria. It has to note that episodic course with progressive deficit and remittent course of paranoid schizophrenia and schizoaffective disorder were pooled in one remission group because of possibility to achieve minimal level and less for all chosen symptoms. Practically all positive symptoms were excluded from remission criteria for simple and residual schizophrenia. Validation of standardized clinic- functional criteria showed that they covered wider range of stable schizophrenic patients as compared to international criteria of remission and provide more realistic target for modern antipsychotic therapy according to various clinical types and courses of schizophrenia

History and current condition of Russian psychiatry

Russian psychiatry has a dramatic history, and until now has been at a transitional stage of development. It is facing problems not only common in world psychiatry, but also specific to eastern Europe, in particular Russia. Starting from the beginning of the 1990s, considerable changes have occurred in psychiatry, especially after 1992 when the law on psychiatric care and guarantees of citizens’ rights in its provision was adopted. It became the ideological and legislative basis for reforms. However, there are definite obstacles to structural reforms in psychiatry. They are unfavourable technical conditions in many psychiatric clinics, hypercentralization of psychiatric services, shortage of clinical psychologists and social workers in psychiatry, some difficulties in cooperation between psychiatric and general medical institutions. Economic difficulties in the transition period of Russia's social development prevent the overcoming of these problems. They are being actively discussed and some of them are being gradually solved, e.g. the organization of team work in mental health services, the increasing number of specialists on social work, and the involvement of non-government organizations in psychosocial rehabilitation.

Victor Kandinsky (1849–89): a pioneer of modern Russian forensic psychiatry

The paper describes Victor Kandinsky's professional achievements within nineteenth-century Russian forensic psychiatry. A thorough review of nineteenth-century Russian psychiatry is presented, followed by a short biographical account of Kandinsky's personal life. Within the backdrop of Russian forensic psychiatry toward the end of nineteenth century, Kandinsky's pioneer innovations in psychopathology and classification as well as his contributions to Russian forensic psychiatry are reviewed. These are exemplified by two of his forensic case studies relating to forensic responsibility and malingering, which are included in his famous book 'On Irresponsibility'.

Some aspects of psychiatry in Russia

The abuse of psychiatry in the former Soviet Union was broadly discussed during the second half of the twentieth century (Spencer, 2000; van Voren, 2010). In the twenty-first century, the interest ...

Psychiatry in Russia: economic upturn must bring improvements

Psychiatry in Russia: economic upturn must bring improvements

Interdisciplinarity and partnership in Russian psychiatry

Interdisciplinarity and partnership in Russian psychiatry