Mental Diseases

human diseases characterized chiefly by disorders of the psyche, or mind. In mental diseases, the reflection of objective reality is impaired, and the patient’s self-awareness, his attitude toward others, and his behavior are altered.

Some mental diseases are the result of primary affection of the brain, followed by a disturbance of the body as a whole. Others are caused by diseases of particular organs, with secondary disturbance of mental functions. Mental diseases are manifested by a variety of disorders: false sensory impressions (illusions, hallucinations), disturbances in thinking (for example, obsessions, delirium) or in mood (for example, depression), disorders of consciousness and memory, and intellectual decline. Because modern science does not possess sufficiently complete, precise ideas concerning the mechanisms of normal mental activity, the mechanisms of disturbed behavior are obscure. The causes of mental diseases include hereditary predisposition; intoxication; diseases of the brain (traumas and tumors, for example), endocrine glands, and internal organs; avitaminosis; and psychological trauma. Abnormal intrauterine development may be a factor in some cases.

According to the conventional nomenclature, there are three main types of mental diseases. The psychoses, including schizophrenia and manic-depressive psychosis, constitute the most important group of mental diseases. Because of the importance of this group, the term “psychoses” was once interpreted broadly as a synonym for “mental diseases.” This interpretation is now obsolete. The second group of mental diseases —borderline nervous and mental disorders—includes neuroses, psychopathies, and other nonpsychotic diseases (notably, narcomania). The third category, mental retardation, includes oligophrenia. The course of mental diseases varies from single or rare attacks with complete remission to severe, chronic psychoses with gross disorganization of mental activity and deterioration into feeblemindedness. The death of mental patients is usually due to the supervention of another disease, an accident, or suicide. Psychiatry is the scientific discipline that studies mental diseases.

In the middle of the 20th century mental illness became one of the most important problems in medicine and public health in economically developed countries. The increased incidence of mental diseases is due primarily to nervous stress associated with the complex society that has developed as a result of the scientific and technological revolution. (At the beginning of the 1970’s it was estimated that throughout the world there were 70 million persons with mental disorders requiring hospitalization. In some economically developed countries the rate was as high as 110–140 persons per 1,000 inhabitants.) Moreover, modern life places growing demands on the individual, often bringing to the surface some forms of mental disorders that would otherwise be counterbalanced. The higher incidence of mental diseases in the 20th century is also attributable to medicine’s increased capability to detect these disorders. In the capitalist countries there are additional, unfavorable conditions promoting a higher incidence of mental diseases, including lack of confidence in the future, owing to the threat of unemployment and fear of thermonuclear war; excessive intensification of labor; and isolation and alienation. Alcoholism and other forms of narcomania have assumed catastrophic proportions in many countries.

Psychotropic drugs are used to treat most mental diseases. In some psychoses, insulin shock therapy and electroshock therapy are used. Psychotherapy is used chiefly to treat neuroses and psychopathies. In the USSR mental patients are treated in a generally accessible network of specialized medical institutions—mental hospitals, dispensaries, day hospitals, and therapeutic workshops. This system makes it possible to observe the principle of continuity and succession in therapy.