laboratories some of these scientists were subjected to torture in prison. the moscow, leningrad, ukrainian, georgian, and armenian schools of neuroscience and neurophysiology were damaged for a period due to this loss of personnel. the joint session ravaged productive research in neurosciences and psychiatry for years to come. pseudo-science took control. following a previous joint session of the ussr academy of sciences and the ussr academy of medical sciences (28 june–4 july 1950) and the 10-15 october 1951 joint session of the presidium of the academy of medical sciences and the board of the all-union society of neuropathologists and psychiatrists, snezhnevky's school was given the leading role. the 1950 decision to give monopoly over psychiatry to the pavlovian school of snezhnevsky was one of the crucial factors in the rise of political psychiatry. the soviet doctors, under the incentive of snezhnevsky, devised a "pavlovian theory of schizophrenia" and increasingly applied this diagnostic category to political dissidents. "sluggish schizophrenia" the incarceration of free thinking healthy people in madhouses is spiritual murder, it is a variation of the gas chamber, even more cruel; the torture of the people being killed is more malicious and more prolonged. like the gas chambers, these crimes will never be forgotten and those involved in them will be condemned for all time during their life and after their death." (alexander solzhenitsyn) psychiatric diagnoses such as the diagnosis of "sluggish schizophrenia" in political dissidents in the ussr were used for political purposes. it was the diagnosis of "sluggish schizophrenia" that was most prominently used in cases of dissidents. sluggish schizophrenia as one of the new diagnostic categories was created to facilitate the stifling of dissidents and was a root of self-deception among psychiatrists to placate their consciences when the doctors acted as a tool of oppression in the name of a political system. according to the global initiative on psychiatry chief executive robert van voren, the political abuse of psychiatry in the ussr arose from the conception that people who opposed the soviet regime were mentally sick since there was no other logical rationale why one would oppose the sociopolitical system considered the best in the world. the diagnosis "sluggish schizophrenia", a longstanding concept further developed by the moscow school of psychiatry and particularly by its chief snezhnevsky, furnished a very handy framework for explaining this behavior. the weight of scholarly opinion holds that the psychiatrists who played the primary role in the development of this diagnostic concept were following directives from the communist party and the soviet secret service, or kgb, and were well aware of the political uses to which it would be put. nevertheless, for many soviet psychiatrists "sluggish schizophrenia" appeared to be a logical explanation to apply to the behavior of critics of the regime who, in their opposition, seemed willing to jeopardize their happiness, family, and career for a reformist conviction or ideal that was so apparently divergent from the prevailing social and political orthodoxy. snezhnevsky, the most prominent theorist of soviet psychiatry and director of the institute of psychiatry of the ussr academy of medical sciences, developed a novel classification of mental disorders postulating an original set of diagnostic criteria. a carefully crafted description of sluggish schizophrenia established that psychotic symptoms were non-essential for the diagnosis, but symptoms of psychopathy, hypochondria, depersonalization or anxiety were central to it. symptoms referred to as part of the "negative axis" included pessimism, poor social adaptation, and conflict with authorities, and were themselves sufficient for a formal diagnosis of "sluggish schizophrenia with scanty symptoms". according to snezhnevsky, patients with sluggish schizophrenia could present as quasi sane yet manifest minimal but clinically relevant personality changes which could remain unnoticed to the untrained eye. thereby patients with non-psychotic mental disorders, or even persons who were not mentally sick, could be easily labelled with the diagnosis of sluggish schizophrenia. along with paranoia, sluggish schizophrenia was the diagnosis most frequently used for the psychiatric incarceration of dissenters. as per the theories of snezhnevsky and his colleagues, schizophrenia was held to be much more prevalent than previously considered, for the illness might present with comparatively slight symptoms, and might only progress afterwards. as a consequence, schizophrenia was diagnosed much more often in moscow than in cities of other countries, as the world health organization pilot study on schizophrenia reported in 1973. the city with the highest prevalence of schizophrenia in the world was moscow. in particular, the scope was widened by sluggish schizophrenia because according to snezhnevsky and his colleagues, patients with this diagnosis were capable of functioning almost normally in the social sense. their symptoms could be like those of a neurosis or could assume a paranoid character. the patients with paranoid symptoms retained some insight into their condition but overestimated their own significance and could manifest grandiose ideas of reforming society. thereby, sluggish schizophrenia could have such symptoms as "reform delusions", "perseverance", and "struggle for the truth". as viktor styazhkin reported, snezhnevsky diagnosed a reformation delusion for every case when a patient "develops a new principle of human knowledge, drafts an academy of human happiness, and many other projects for the benefit of mankind". in the 1960s and 1970s, theories, which contained ideas about reforming society and struggling for truth, and religious convictions were not referred to delusional paranoid disorders in practically all foreign classifications, but soviet psychiatry, proceeding from ideological conceptions, referred critique of the political system and proposals to reform this system to the delusional construct. diagnostic approaches of conception of sluggish schizophrenia and paranoiac states with delusion of reformism were used only in the soviet union and several eastern european countries. on the covert orders of the kgb, thousands of social and political reformers—soviet "dissidents"—were incarcerated in mental hospitals after being labelled with diagnoses of "sluggish schizophrenia", a disease fabricated by snezhnevsky and "moscow school" of psychiatry. american psychiatrist alan a. stone stated that western criticism of soviet psychiatry aimed at snezhnevsky personally, because he was essentially responsible for the soviet concept of schizophrenia with a "sluggish type" manifestation by "reformerism" including other symptoms. one can readily apply this diagnostic scheme to dissenters. snezhnevsky was long attacked in the west as an exemplar of psychiatric abuse in the ussr. the leading critics implied that snezhnevsky had designed the soviet model of schizophrenia and this diagnosis to make political dissent into a mental disease. 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, and, in dozens of cases, he personally signed a commission decision on legal insanity of mentally healthy dissidents including vladimir bukovsky, natalya gorbanevskaya, leonid plyushch, mikola plakhotnyuk, and pyotr grigorenko. beginning of the trend toward mass abuse from khrushchev to andropov the campaign to declare political opponents mentally sick and to commit dissenters to mental hospitals began in the late 1950s and early 1960s. as vladimir bukovsky commented on the emergence of the political abuse of psychiatry, nikita khrushchev reckoned that it was impossible for people in a socialist society to have an anti-socialist consciousness. whenever manifestations of dissidence could not be justified as a provocation of world imperialism or a legacy of the past, they were self-evidently the product of mental disease. in a speech published in the pravda daily newspaper on 24 may 1959, khrushchev said: a crime is a deviation from generally recognized standards of behavior frequently caused by mental disorder. can there be diseases, nervous disorders among certain people in a communist society? evidently yes. if that is so, then there will also be offences, which are characteristic of people with abnormal minds. of those who might start calling for opposition to communism on this basis, we can say that clearly their mental state is not normal. yuri andropov (1914–1984), a kgb chairman and general secretary of the cpsu the now available evidence supports the conclusion that the system of political abuse of psychiatry was carefully designed by the kgb to rid the ussr of undesirable elements. according to several available documents and a message by a former general of the fifth (dissident) directorate of the ukrainian kgb to robert van voren, political abuse of psychiatry as a systematic method of repression was developed by yuri andropov along with a selected group of associates. andropov was in charge of the wide-ranging deployment of psychiatric repression from the moment he was appointed to head the kgb. he became kgb chairman on 18 may 1967. on 3 july 1967, he made a proposal to establish a fifth directorate (ideological counterintelligence) within the kgb to deal with internal political opposition to the soviet regime. the directorate was set up at the end of july and took charge of kgb files on all soviet dissidents, including andrei sakharov and alexander solzhenitsyn. in 1968, kgb chairman andropov issued a departmental order "on the tasks of state security agencies in combating the ideological sabotage by the adversary", calling for the kgb to struggle against dissidents and their imperialist masters. his aim was "the destruction of dissent in all its forms" and he insisted that the positions of the capitalist countries on human rights, and their criticisms of the soviet union and its own politics of human rights from these positions, was just one part of a wide-ranging imperialist plot to undermine the soviet state's foundation. similar ideas can be found in the 1983 book speeches and writings by andropov published when he had become general secretary of the cpsu: hen analyzing the main trend in present-day bourgeois criticism of human rights policies one is bound to draw the conclusion that although this criticism is camouflaged with "concern" for freedom, democracy, and human rights, it is directed in fact against the socialist essence of soviet society... implementation and the legal framework on 29 april 1969, andropov submitted an elaborate plan to the central committee of the communist party of the soviet union to set up a network of mental hospitals that would defend the "soviet government and the socialist order" from dissenters. to persuade his fellow politburo members of the risk posed by the mentally ill, andropov circulated a report from the krasnodar region. a secret resolution of the ussr council of ministers was adopted. andropov's proposal to use psychiatry for struggle against dissenters was adopted and implemented. in 1929, the ussr had 70 psychiatric hospitals and 21,103 psychiatric beds. by 1935, this had increased to 102 psychiatric hospitals and 33,772 psychiatric beds, and by 1955 there were 200 psychiatric hospitals and 116,000 psychiatric beds in the soviet union. the soviet authorities built psychiatric hospitals at a rapid pace and increased the quantity of beds for patients with nervous and mental illnesses: between 1962 and 1974, the number of beds for psychiatric patients increased from 222,600 to 390,000. such an expansion in the number of psychiatric beds was expected to continue in the years up to 1980. throughout this period the dominant trend in soviet psychiatry ran counter to the vigorous attempts in western countries to treat as many as possible as out-patients rather than in-patients. on 15 may 1969, a soviet government decree (no. 345–209) was issued "on measures for preventing dangerous behavior (acts) on the part of mentally ill persons." this decree confirmed the practice of having undesirables hauled into detention by psychiatrists. soviet psychiatrists were told whom they should examine and were assured that they might detain these individuals with the help of the police or entrap them into coming to the hospital. the psychiatrists thereby doubled as interrogators and as arresting officers. doctors fabricated a diagnosis requiring detention and no court decision was required for subjecting the individual to indefinite confinement in a psychiatric institution. by the end of the 1950s, confinement to a psychiatric institution had become the most commonly used method of punishing leaders of the political opposition. in the 1960s and 1970s, the trials of dissenters and their referral for "treatment" to the special psychiatric hospitals under mvd control and oversight came out into the open, and the world learned of a wave of "psychiatric terror" which was flatly denied by those in charge of the serbsky institute. the bulk of psychiatric repression spans the period from the late 1960s to the early 1980s. as cpsu