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FINAL REPORT TO NATIONAL COUNCIL FOR SOVIET AND EAST EUROPEAN RESEARC H Soviet Psychiatry TITLE Th e Historical and Cultural Contex t AUTHOR CONTRACTOR Martin A Miller Duke Universit y Martin A Mille r PRINCIPAL INVESTIGATOR COUNCIL CONTRACT NUMBER DATE 626 9 May 198 6 The work leading to this report was supported by funds provide d by the National Council for Soviet and East European Research EXECUTIVE SUMMARY Madness under communism is an indisputable fact What i s unclear is the extent of its presence in the Soviet Union Official Soviet publications report that about 2 of the genera l population suffers from severe mental disorders a rate comparabl e to that for the United States Some practitioners of Sovie t psychiatry who have made their way to the West believe that th e incidence is at the higher rate of approximately 5 of th e population If the higher figure for the USSR is correct an d rising according to some emigre psychiatrists and psychologists there are millions less people who are capable of functionin g effectively in the military and in the workplace than we hav e assumed and the cost of maintaining such a large dependen t population is substantial enough to affect the national economy The Soviet Union despite marked advances in psychiatri c services in recent decades is not equipped to deal with th e personal and psychological problems which the system continuall y generates Schizophrenia and alcoholism figure prominently i n Soviet studies of ills that plague their society Other problem s such as drug abuse domestic violence delinquency crime an d sexual problems as manifestations of mental illness are rarel y subjects of serious psychiatric study in a society which continue s to downplay or deny their presence in a communist order This report is a study of mental illness in the Soviet Unio n and of the psychiatric profession which treats it The sources available for such a study consist of published Soviet psychiatri c literature in the form of

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