Psychiatry and Addiction Medicine in Russia: Spots of Bother

What is it about?

Selected aspects of Russian psychiatry and addiction medicine are delineated in this review. Some cited literature is not new as ethical issues are less openly discussed nowadays. Certain human factors have remained unchanged since the Soviet time, so that persistence or relapse of abusive practices is not excluded. Two case reports are presented, illustrating, how the diagnosis may depend on the patient’s social status. Vague diagnostic criteria of sluggish schizophrenia affected many people, having nothing to do with politics or dissent. Personality disorders, neuroses and transient derangements in adolescence have been diagnosed and treated as schizophrenia. Along with the extended diagnostic criteria of the disease, a broader concept of social dangerousness has been applied, facilitating hospitalization. Antipsychotics have been recommended for all varieties of schizophrenia. Furthermore, the use of neuroleptics for treating alcoholism and other addictions in Russia extends beyond internationally accepted indications. Overtreatment of patients diagnosed with alcohol use disorder, discussed in зreceding papers, is briefly summarized here. Conditions in psychiatric hospitals, where patients stay for long time, are briefly tackled. Some institutions are investing in major repairs of buildings but overcrowding persists both in wards and in restrooms. In conclusion, temporary practice of Russian doctors abroad and of authorized foreign advisors in Russia is recommended.

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