Is "sluggish schizophrenia" just a Soviet concept?

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When I look at wikipedia description of "sluggish schizophrenia" https://en.wikipedia.org/wiki/Sluggish_schizophrenia they act like its just a soviet phenomenon. But they totally ignore the fact that

1. In America back in the 60-s and earlier, autistics were labeled as schizophrenics

2. In today's psychiatry (both in the USA and in Western Europe) there is a diagnosis of Schizotypal (personality) disorder that means pretty much the same thing as "sluggish schizophrenia"

One could attempt to argue that maybe western medicine borrowed it from Soviets. But no, thats not true either. If you look at the dates, Soviets used that term under Brezhnev, and Brezhnev came to power in 1964. But in America schizophrenia was used on autistics back in the 50-s too, and probably much earlier.

I personally tend to think that the phenomenon of over-diagnosing schizophrenia was a worldwide thing, and Soviets just took advantage of it. Capitalist countries took advantage of it too -- just for their own purposes.

By the way, to give Soviets credit, if you go to this page ( https://en.wikipedia.org/wiki/Lobotomy ) soviets were the FIRST to abandone lobotomy. In fact in Soviet Union lobotomy existed for only few years while in America it existed for few decades. But if you are going to just ignore the rest of the world and talk JUST about Soviet Union then you would be like "oh wow, thats how cruel Stalin was!" But if you look at all countries side by side, you find that it has nothing to do with it and, in fact, Soviets were the last to adopt it and the first to reject it.

The old USSR saw itself as the "workers paradise" so if anyone were unhappy about life there then...they must be insane. Ergo..all dissenters are insane. Ergo lock up all dissenters in the booby hatch!

It was obviously a politically motivated diagnosis that had nothing to do with medicine, and everything to do with squashing dissent. That's why the diagnosis was discredited outside of the Soviet Bloc.

That doesn't mean that Soviet shrinks didn't sometimes do good innovative things. They do deserve kudos for getting rid of lobotomies quicker than the US did if that's true that they did that. And there was a Soviet woman researcher on children back in the Twenties who discovered what we now call "autism" years before either the Austrian Hans Asperger, or the American Leo Kanner, published their findings.

Was it? The DSM 4, that is used in America, has "schizotypal personality disorder" in it. And ICD 10, that's used in Europe, has "schizotypal disorder" in it. Those diagnoses mean the same thing as "sluggish schizophrenia".

Maybe look into the history of the usage of the word “schizophrenia”: it’s had quite a few different meanings applied to it over the last hundred and more years.

They do not mean the same thing. And the Wiki article you link to even says that the diagnosis was always discredited outside of the Soviet Bloc.

They do. Both mean that you don't have schizophrenia as such, but you have a very mild version of that same phenomenon.

By the way, DSM 4 also has a mention of "simple schizophrenia" as well -- although its not a diagnostic category as such but rather an entity "under research".

So if you take schizotypal personality disorder on one end, and simple schizophrenia on the other end, this kinda cover the territory of where "sluggish schizophrenia" might fall into.

And also don't forget how, in the past, autistics were massively misdiagnosed as schizophrenics.

The diagnosis of "sluggish schizophrenia" was obviously contrived in order to put away political prisoners in order to conceal the fact that they were political prisoners. Therefore the term cant be used anymore. The fact that it vaguely resembles some actual accepted diagnosis is irrelevant.

There is another Wiki article entitle "the political abuse of psychiatry in the Soviet Union". I don't know how to make links to Wiki.

The point is that the "official" criteria for sluggish schizophrenia doesn't include political dissent. Instead, it reads similar to how schizotypal personality disorder reads. They just "used" it on political dissidents. The diagnosis for schizotypal personality disorder can be "used" that way too. One of the criteria of schizotypal is "odd beliefs" with an added clarification that they are unusual for specific cultural settings. So, in a country that wants to push a political ideology, they can always say "this person disagrees with the ideology while most people agree, so they have odd belief that don't fit cultural norm" (where the term "cultural norm" includes the specific politics of the country) and use it as a reason to diagnose them with Schizotypal Personality Disorder.

By the way, I read the Soviet book "Аутизм у детей" by Каган ("Autism in Children" by Kahan), written in 1981, and in the introduction they said that there is an opinion that autism might be a form of sluggish schizophrenia -- which is the exact misconception about autism that was prevalent in America in the 60-s. Since this has nothing to do with political discent, it points to the idea that "sluggish schizophrenia" was really the same phenomenon as what happened across the globe, its just that "sometimes" it was used on political dissidents -- although "other times" it was used for the things that people elsewhere were using it for.

There was a concept known as “simple schizophrenia” back in the 1970s in the US.

Supposedly, in “simple schizophrenia,” there was a noticeable absence of “positive” symptoms such as delusions and hallucinations, combined with a noticeable presence of “negative” symptoms such as apathy, “poverty of ideas,” and flat affect. One could say that a “simple” schizophrenic would be “sluggish.”

Some autistic people, especially “high-functioning” people, were diagnosed with “childhood schizophrenia” about 50 years ago. More severely-affected people were diagnosed with “infantile autism.”

So autism is actually "worse" than schizophrenia. Interesting.

Autism had a much worse prognosis than most of schizophrenia in the 1970s. What is now “high-functioning” autism wasn’t really a mainstream concept then. Hans Asperger was an obscure figure then.

“Childhood Schizophrenia” was considered very unlike adult schizophrenia.

So, to put it another way, there are three categories of people:

1) Severely autistic
2) Schizophrenic
3) What we now consider HFA and Asperger

So 1 and 2 were separate back then and now. The only thing that changed is that, in the past, item 3 was grouped together with item 2, and today item 3 is being grouped with item 1. Thus, 1 and 2 stayed where they were, while item 3 have "traveled" from 2 to 1.

I could be wrong, but I am pretty sure that in the Soviet concept of "sluggish schizophrenia" it was the condition that was "sluggish", and not the person. The schizophrenia progressed at a sluggish pace compared to that of your typical psychotic who might just obviously loose their sanity over night.

In fact...the schizophrenia of the patients involved was SO sluggish in its progression that....the person would die of natural old age long before they got to the finish line (the finish line being actually manifesting insanity)....because it wasn't real schizophrenia to begin with because the patients were actually sane political prisoners .Lol!

In other words "the guy looks sane now, but trust me, he is slowly going bonkers. So we will call his condition 'sluggish insanity'".

How did you get THAT out of what he said?

Its more: one and two were lumped together (severe autism was considered 'childhood schzophrenia'), except even then they were considered as being quite different things despite the similar label.

And three was the empty set. It just wasn't even recognized as a category.

Folks who TODAY would be labeled as three... back then would either just be considered neurotic weirdos who needed talk therapy to cure their bad parenting, or some might have been classified as one (autistic), and later migrated to HFA as they got higher functioning and as HFA/aspergers became a category as science progressed. I was the former. Krafty (if I am not mistaken) is an example of the later.

And now we have all three categories. But one and three are thought of as being on one continuum.

I was considered severely autistic.

When I started talking at age 5, it was changed to “brain damage/injury/minimal brain dysfunction.”

I went to a special school from Kindergarten to 5th grade, then a public school from 6-8th grade, then a special high school for “gifted underachievers.”

Eventually, it was thought that I was a “troubled kid” who needed behavioral modification and attitude adjustment. I exhibited many Aspergian-type symptoms after I started to talk.

I discovered Asperger’s when I was in my late 20s.

An adult schizophrenic was never considered autistic.

It’s possible that the more severe “childhood schizophrenics” might have been considered autistic.

The less severe childhood schizophrenics might have been considered to have “minimal brain dysfunction,” or to have “adjustment problems,” “perceptual problems,” and others of that ilk. Other kids in those categories were not considered childhood schizophrenics

The concept of HFA became somewhat mainstream in the 1980s. Asperger’s Syndrome became mainstream in the 1990s.