Sluggish Schizophrenia in the Modern Classification of Mental Illness

Abstract

The concept of latent schizophrenia was developed by E. Bleuler (1911) and was further promoted in the studies of a number of research psychiatric schools of Europe, the United States, Japan, and other countries. In Soviet psychiatry, there is a long-established tradition of studying "soft" forms of schizophrenia (Kerbikov 1933; Rozenshtein 1933; Brukhanskii 1934). In the systematics of schizophrenia, developed by Snezhnevsky (1969) and his colleagues, sluggish schizophrenia is viewed not as an initial (prodromal) stage of schizophrenia, but rather an independent diagnostic category characterized by a slowly progressive course, subclinical manifestations in the latent period, overt psychopathological symptoms in the active period, and then by a gradual reduction of positive symptoms, with negative symptoms predominating the clinical picture during patient stabilization. Studies are reviewed examining the relationship of constitutional and genetic factors to the clinical manifestation of sluggish schizophrenia. Finally, the importance of methodological considerations and an examination of divergent factors in the U.S. and Soviet concepts of schizophrenia are presented.

Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress—Protective Activity

“…For example, some patients who would be diagnosed as having psychotic depression, schizotypal disorder, schizoaffective disorder, or bipolar disorder by a non-Soviet psychiatrist would have been diagnosed as schizophrenic by a Soviet psychiatrists [166,167,168]. Indeed, the term “sluggish-schizophrenia” was particularly misused [172]. The diagnoses of asthenia and neuroasthenia include a very heterogeneous group of patients with mixed psychological and physical disorders, making the studies more difficult to interpret.…”

Association of Rorschach and MMPI Psychosis Indicators and Schizophrenia Spectrum Diagnoses in a Russian Clinical Sample

“…latent or prodromal schizophrenia in the West (Smulevich, 1989; also see Table 1). Schizophrenia spectrum disorders were operationalized using each diagnostic system as follows.…”

“…In the "Moscow school" of psychiatric diagnosis, a configural approach is used for schizophrenia whereby the course and the current syndrome are considered separately, and latent forms of schizophrenia are routinely diagnosed (Calloway, 1988(Calloway, , 1993Lavretsky, 1998;Smulevich, 1989;Snezhnevskii, 1983). For example, clinicians distinguish between slowly progressive, episodic, and attack-like course types in addition to the more familiar distinctions between syndrome types such as catatonic and paranoid.…”

“…It was beyond the scope of this study to investigate the relationship of specific diagnoses to one another or to evaluate the validity of the diagnoses. (For further details in English about the Moscow school of psychiatry and various points of view on the diagnosis of schizophrenia in the Soviet Union and Russia, see Andreyev, 1986;Calloway, 1988Calloway, , 1993Lavretsky, 1998;Reddaway, 1978;Smulevich, 1989). All three diagnostic systems were used in this study because there was no empirical or expert consensus that any one system was preferable as the "gold standard" to use in validating the psychological measures.…”

Some aspects of psychiatry in Russia

“…), unusual interests, eccentricity and so forth were presented as diagnostic criteria for schizophrenia. Existence of non-symptomatic (Smulevich, 1989) or non-manifestative (Il'ina, 2006) schizophrenia was postulated as well. At the same time, sluggish schizophrenia was reported to be the most common form of the disease (Korkina, Lakosina, Lichko, & Sergeev, 2004;Polishchuk, 2001;Snezhnevsky, 1986).…”