Wing J K
Br Med J. 1974 Mar 9;1(5905):433-6. doi: 10.1136/bmj.1.5905.433.
The services for chronically handicapped people with psychiatric disorders in the Soviet Union are described. The system is based upon a network of community units, each of which includes a day centre, a follow-up clinic, and a sheltered workshop. British services could profitably learn from the experience of these units. The diagnostic system used by many Soviet psychiatrists is different from that incorporated in the International Classification of Diseases. In particular, the term "schizophrenia" is used to describe conditions which British psychiatrists would label in other ways.This clinical difference partly explains the different concept of "criminal responsibility," but another large component of the difference is political rather than medical. There are also variations from British practice in certain juridical procedures. These differences together make Soviet psychiatric practice in the case of political dissenters unacceptable to most British psychiatrists. It is too soon to say that frank discussions of these matters could not lead to improvement. British and Soviet psychiatrists still have something to learn from each other.
本文描述了苏联为患有精神疾病的慢性残疾人提供的服务。该体系基于社区单位网络，每个社区单位都包括一个日间中心、一个随访诊所和一个庇护工场。英国的服务机构可以从这些单位的经验中受益。许多苏联精神病医生使用的诊断系统与《国际疾病分类》中的不同。特别是，“精神分裂症”一词被用来描述英国精神病医生会用其他方式标注的病症。这种临床差异部分解释了“刑事责任”的不同概念，但差异的另一个主要因素是政治而非医学方面的。在某些司法程序上也与英国的做法有所不同。这些差异共同导致大多数英国精神病医生无法接受苏联在处理持不同政见者案件时的精神病学做法。现在说对这些问题进行坦诚讨论不会带来改善还为时过早。英国和苏联的精神病医生仍有相互学习之处。
