May 7, 1904|
|Died||July 12, 1987
Moscow, Soviet Union
|Residence||Russian Empire →
|Alma mater||Kazan Federal University|
Andrei Vladimirovich Snezhnevsky (Russian: Андре́й Влади́мирович Снежне́вский) (7 (20) May 1904, Kostroma — 12 July 1987, Moscow) was a Soviet psychiatrist notorious for expanding the diagnostic criteria for schizophrenia, a step that allowed for arbitrary labeling of political dissidents as having sluggishly progressing schizophrenia. He was an academician of the USSR Academy of Medical Sciences,:221 the director of the Serbsky Institute for Forensic Psychiatry (1950—1951),:221 the director of the Institute of Psychiatry of the USSR Academy of Medical Sciences (1962—1987):220, and the director of the All-Union Mental Health Research Center of the USSR Academy of Medical Sciences (1982—1987).
Snezhnevsky was long attacked in the West as an exemplar of political abuse of psychiatry in the Soviet Union. He was charged with cynically developing a system of diagnosis which could be bent for political purposes, and he himself diagnosed or was involved in a series of famous dissident cases, including those of the biologist Zhores Medvedev and the mathematician Leonid Plyushch.
In 1980, the Special Committee on the Political Abuse of Psychiatry, established by the Royal College of Psychiatrists in 1978, charged Snezhnevsky with involvement in the abuse:223 and recommended that Snezhnevsky, who had been honoured as a Corresponding Fellow of the Royal College of Psychiatrists, be invited to attend the College's Court of Electors to answer criticisms because he was responsible for the compulsory detention of this celebrated dissident, Leonid Plyushch. Instead Snezhnevsky chose to resign his Fellowship.
Snezhevsky wrote the letter to the president of the Royal College:
The Royal College has taken a very dubious function of intervening into the inner affairs of national psychiatric associations and using mentally-ill patients for political purposes. I sincerely hope that none of the members… seriously believes that in the Soviet Union mentally-healthy people could be forcibly put into mental hospitals.:329
According to the psychiatrist Marina Voikhanskaya, Academician Snezhnevsky and his “school” have debased, reduced Russian psychiatry to a semi-amateur level and single doctrine about schizophrenia, in the terms of which alcoholic psychoses and alcoholism are considered schizophrenia; congenial idiocy in the children of alcoholics is considered premature schizophrenia; and dissent is considered schizophrenia with delusions of reform.:458
As reported by the psychiatrist Boris Zoubok, who worked at the Kashchenko hospital under Snezhnevsky and afterwards settled in the USA, Snezhnevsky and his colleagues genuinely believed in their concept of dissent as mental disease and in the method of diagnosis.:228
According to Moscow psychiatrist Alexander Danilin, the so-called ‘nosological’ approach in the Moscow psychiatric school established by Snezhnevsky boils down to the ability to make an only diagnosis, schizophrenia; psychiatry is not science but such a system of opinions and people by the thousands are falling victims to these opinions—millions of lives were crippled by virtue of the concept ‘sluggish schizophrenia’ introduced some time once by Andrei Vladimirovich Snezhnevsky, academician, whom Danilin called a political offender.
On basis of the available data and materials accumulated in the archives of the International Association on the Political Use of Psychiatry, one can confidently conclude that thousands of dissenters were hospitalized for political reasons.
St Petersburg academic psychiatrist professor Yuri Nuller notes that the concept of Snezhnevsky’s school allows, for example, to consider schizoid psychopathy or schizoidism as the early, sluggishly progressing stages of an inevitable progredient process rather than the personality characteristics of an individual, which may not develop along the path of schizophrenic process at all. That results in the extreme expansion of diagnosing sluggish schizophrenia and the harm it has done. Nuller adds that within the scope of the sluggish schizophrenia concept, any deviation from the norm evaluated by a doctor can be regarded as schizophrenia, with all the ensuing consequences for an examinee. That creates ample opportunity for voluntary and involuntary abuses of psychiatry. However, neither Snezhnevsky nor his followers, according to Nuller, found civil and scientific courage to review their concept, which clearly reached a deadlock.
Helen Lavretsky suggests that a totalitarian regime, the lack of a democratic tradition in Russia, and oppression and “extermination” of the best psychiatrists during the 1930-50 period prepared the ground for the abuse of psychiatry and Russian-Soviet concept of schizophrenia.
In 1968 Snezhnevsky wrote of a distinction between the positive and negative symptoms of schizophrenia,:164 a concept long attributed to Snezhnevky but in fact introduced by John Hughlings Jackson and John Russell Reynolds. The concept came to be increasingly used in schizophrenia research and classification since 1970's, citing his colleague I.F. Ovchinnikov that the symptoms appear to exist "as if on two levels".
- Bloch, Sidney; Reddaway, Peter (1977). Russia's political hospitals: The abuse of psychiatry in the Soviet Union. Victor Gollancz Ltd. ISBN 0-575-02318-X.
- Reich, Walter (30 January 1983). "The world of Soviet psychiatry". The New York Times. Retrieved 1 January 2011.
- Calloway, Paul (1993). Russian/Soviet and Western psychiatry: a contemporary comparative study. Wiley. p. 223. ISBN 0-471-59574-8.
- Levine, Sidney (May 1981). "The Special Committee on the Political Abuse of Psychiatry". Psychiatric Bulletin 5 (5): 94–95. doi:10.1192/pb.5.5.94. Retrieved 3 March 2011.
- (Russian) Данилин, Александр (28 марта 2008). "Тупик". Русская жизнь. Retrieved 21 April 2011.
- van Voren R. (2010). "Political Abuse of Psychiatry—An Historical Overview". Schizophrenia Bulletin 36 (1): 33–35. doi:10.1093/schbul/sbp119. PMC 2800147. PMID 19892821.
- (Russian) Нуллер, Юрий (1993). Парадигмы в психиатрии. Киев: Видання Асоціації психіатрів України.
- (Russian) Нуллер (1991). "О парадигме в психиатрии". Обозрение психиатрии и медицинской психологии имени В.М. Бехтерева (Институт им. В.М. Бехтерева) (№ 4).
- Lavretsky H. (1998). "The Russian Concept of Schizophrenia: A Review of the Literature". Schizophrenia Bulletin 24 (4): 537–557. doi:10.1093/oxfordjournals.schbul.a033348. PMID 9853788.
- Tandon, Rajiv; Greden, John F. (1991). Negative schizophrenic symptoms: pathophysiology and clinical implications. Washington, DC: American Psychiatric Press. ISBN 0-88048-192-7.
- Мосолов С.Н. [Mosolov S.N.] (2006). "Спорные и малоизученные вопросы практического использования антипсихотической фармакотерапии у больных шизофренией (анализ результатов интерактивного опроса врачей) [Controversial and poorly understood issues of the practical use of antipsychotic drug therapy in patients with schizophrenia (analysis of the results of the online survey of physicians)]". Современная терапия психических расстройств [Modern treatment of mental disorders] (1).
- Snezhnevsky AV. The symptomatology, clinical forms and nosology of schizophrenia, in Modern perspectives in World Psychiatry. Edited by Howells JG. Edinburgh, Oliver and Boyd, 1968, pp 425-447
- "Behavior: The Children of Pavlov". Time. June 23 1980.
- Reich W. (January 30 1983). "The World of Soviet Psychiatry". The New York Times (USA).
- van Voren, Robert (2009). On Dissidents and Madness: From the Soviet Union of Leonid Brezhnev to the "Soviet Union" of Vladimir Putin. Amsterdam—New York: Rodopi. ISBN 978-90-420-2585-1.
- The letter Tatiana Zhitnikova, Leonid Plyushch’s wife, wrote to Sneshnevsky on 14 February 1973 and published in Ходорович Т.С., ed. (1974). История болезни Леонида Плюща. Амстердам: Фонд им. Герцена. pp. 124–127.