Intended for healthcare professionals

Rapid response to:


A patient's journey: living with paranoid schizophrenia

BMJ 2006; 333 doi: (Published 21 September 2006) Cite this as: BMJ 2006;333:636

Rapid Response:

Inheritance from the Soviets

A lot of similar examples,as described in Stuart Baker-Brown's "A
patients journey..."could be met at my end , in Lithuania. We are so quick
to define paranoya and to give a prescription for Olanzapine, Risperidone,
or any other neuroleptic.I think,it is becoming a luxary for our patient
to become granted with true attention,compassion and understanding- not
only the psychopathology, but his or her needs,humanistic feelings.
Firstly we are quick to look for and to find the symptomps!Findig
delusions, we leave the patient to develop depression next-as so nicely
presented in the story.Soviet surroundings could course a fear to many.
This fear could be adequate, and should be differentiated from paranoya.
Living in Soviet system, created that style of life-when one should be
very cautious,what to say,to whom to say, to be tense all the time. Even
the "best friends" were the agents of the KGB, that was our reality.As God
was taken away from us by force-to pray -was a crime,so people were
praying secretly,or could be diagnosed as having delusions.Long years of
Soviet occupation has left it's cultural inheritance- a conflict between
the Lithuania nation and religion, and surroundings- you were aloowed to
see the wold the way , as it was suggested. Any real seeing was
delusion...Still the healing is in process. As well as the way,the doctors
psychiatrists performance.

Competing interests:
Transcultural psychiatry, content of delusions

Competing interests: No competing interests

30 September 2006
Palmira Rudaleviciene
Consultant Psychiatrist, Chairman of the Lithuanian Cultural Psychiatry Association
Vilnius Mental Health Center