“Sluggish schizophrenia” was a fictional diagnosis used in the Soviet Union following the Second World War. It was a political tool that the government employed to oppress anti-Soviet dissenters. Outside of the Soviet Union, medical bodies such as the World Health Organization never officially recognized the diagnosis.

Although sluggish schizophrenia does not exist as a medical diagnosis, schizophrenia is a very real and serious mental health disorder. People living with schizophrenia may experience hallucinations, delusions, or catatonic behavior. Schizophrenia is a challenging condition that can severely affect a person’s quality of life. Therefore, early diagnosis and treatment are crucial.

This article looks at sluggish schizophrenia and its history. It also looks at schizophrenia and when a person should seek help.

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Sluggish schizophrenia was a mental health diagnosis used in the Soviet Union during the post-World War II era. Doctors used it to describe a supposed form of schizophrenia with a slow, progressive course. However, people could receive a diagnosis even if they showed no symptoms of schizophrenia or psychosis, as doctors alleged that symptoms could appear at any time.

The Institute of Psychiatry of the Academy of Medical Sciences of the USSR defined three forms of schizophrenia depending on whether the condition was continuous, recurrent, or mixed.

The subtypes of continuous schizophrenia were:

  • sluggish
  • moderately progressive (paranoid)
  • malignant juvenile

According to research from that era, people with sluggish schizophrenia experienced:

  • flatness
  • laden thoughts
  • incongruity of affect, meaning a person might have a happy appearance and thoughts when talking about a sad event
  • neurasthenic complaints, or feelings of increased fatigue after mental effort
  • depressed or elated mood

A Soviet psychiatrist named Andrei Snezhnevsky developed the diagnostic criteria for sluggish schizophrenia in the 1960s. Psychiatrists and doctors in the USSR and some other Eastern Bloc countries used it until 1989, when the fall of communism began.

The Soviet Union’s approach to mental illness, in general, was quite different from that of the Western world. In the USSR, systemic political abuse of psychiatry took place, and authorities used false psychiatric diagnoses as a tool to suppress political dissent.

Many experts believe that Snezhnevsky developed the sluggish schizophrenia concept due to requests from the Communist Party. The theory was that anyone who opposed the Soviet regime was mentally ill, because there was no other reason for their behavior. Further, diagnosing individuals with sluggish schizophrenia became a tool for handling political dissent.

Individuals involved in the publication or distribution of anti-state literature or political activism were targets. Psychiatrists would incarcerate these individuals in mental institutions without any medical justification. Under Soviet law of the time, these people could be isolated in maximum security hospitals or prison camps.

Sluggish schizophrenia was discredited because it had no scientific basis and was a fictional diagnosis. As a result, it only ever existed as a diagnosis in the Soviet Union and was not recognized elsewhere.

It was one of the infamous diagnoses that Soviet psychiatrists used against political nonconformists. Once doctors discharged someone with sluggish schizophrenia from the hospital, they would lose their civil rights and be unable to find employment.

Using diagnoses in this manner was a form of systemic political abuse of psychiatry and has been internationally condemned.

The classifications and types of schizophrenia have changed over time, and there are no longer any diagnoses similar to sluggish schizophrenia.

Doctors and psychiatrists diagnose mental health conditions using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). In 2013, the classification of schizophrenia types changed. The previous version of the DSM — the 4th edition — listed five types of schizophrenia:

However, the DSM-5 no longer recognizes these features of schizophrenia as distinct subtypes. Instead, mental health professionals may diagnose someone with schizophrenia if they have two or more of the following symptoms:

  • delusions
  • hallucinations
  • disorganized speech
  • extremely disorganized or catatonic behavior
  • reduced emotional expression
  • lack of motivation

For doctors to diagnose schizophrenia, at least one of a person’s symptoms must be delusion, hallucination, or disorganized speech. Additionally, an individual’s symptoms must be severe enough to interfere with daily life.

Schizophrenia can occur at any age. However, the average age of onset in males is late teens to early 20s, while it is late 20s to early 30s for females. Doctors rarely diagnose schizophrenia in people older than age 40 years or younger than 12 years.

Around 0.25% to 0.64% of adults in the United States live with schizophrenia. In comparison, it affects just 0.04% of children.

Learn more about schizophrenia in childhood here.

Schizophrenia is a serious mental illness that can be disabling and have severe health consequences. Over half of people with schizophrenia have significant comorbidities, meaning they have other mental and physical health conditions. Additionally, schizophrenia can negatively affect life expectancy and increase an individual’s risk of suicide.

Due to the disabling effects of schizophrenia, people living with the condition must have adequate medical support. Early diagnosis and treatment can make a big difference in long-term outcomes.

Therefore, if a person shows signs of schizophrenia or other mental health struggles, they should contact a doctor for urgent help.

Sluggish schizophrenia was a diagnosis that doctors in the Soviet Union used to justify the abuse of political dissidents. The diagnosis had no scientific basis and was only ever used in the USSR. It has since been discredited.

However, schizophrenia is still a recognized mental illness that can be disabling and negatively affect a person’s quality of life. Therefore, early diagnosis and treatment are essential for people with schizophrenia.