SUMMARY:

Between 1931 and 1936, psychiatrists in the Soviet Union diagnosed large numbers of people with “mild schizophrenia,” a “neurosis-like” form of schizophrenia that was allegedly unique to the USSR. In 1936 the USSR Commissariat of Public Health intervened, dissolving the research institute most associated with “mild schizophrenia” and fundamentally reorienting the discipline of psychiatry away from “borderline illness” and problems of psychological adjustment and toward major mental illness and its biological causes. This article examines the origins of the “mild schizophrenia” concept and seeks to understand why the Soviet government saw “mild schizophrenia” as a problem. More broadly, it examines the relationship between psychiatric expertise and the state during the period of high Stalinism. The author finds that the concept of “mild schizophrenia” was closely associated with psychiatrists at the Institute of Neuropsychiatric Prophylaxis, particularly its director, Lev Rozenshtein. In the 1920s these psychiatrists sought to create a new discipline, psikhogigiena, which they identified as part of the international mental hygiene movement established by American psychiatrist Adolf Meyer. The Soviet mental hygienists envisioned a countrywide network of “neuropsychiatric dispensaries” that would study environmental and social conditions in order to improve mental health and prevent mental illness. This work brought Rozenshtein and his colleagues into conflict with the Communist Party authorities. Using the category of “mild schizophrenia,” psychiatrists were attempting to define normalcy in terms of psychometric and social indices, not in terms of political or ideological consciousness. Party authorities insisted that medical expertise gave jurisdiction only over specific types of illness, not over conditions of work and life in general. In response Rozenshtein and his colleagues reformulated their claims in the form of a biological disease entity, “mild schizophrenia.” By disbanding Rozenshtein’s institute and denouncing the concept of “mild schizophrenia,” authorities reestablished firm jurisdictional boundaries for psychiatrists. As a result, Soviet psychiatry was oriented firmly toward a conception of psychiatric illness as biological disease.