The political use of psychiatry: A comparison between totalitarian regimes

Background: After the end of Second World War, the recent experience of the Nazi horrors stimulated a debate about the political use of psychiatry. Over the years, the focus shifted on major dictatorships of the time and especially on Soviet Union. Aims: This article aims to provide a critical review of the ways in which psychiatry was used by totalitarian regimes of the 20th century. Methods: We summarized relevant literature about political use of psychiatry in totalitarian regimes of the 20th century, with particular focus on Fascism, Nazism, Argentina dictatorship, Soviet Union and China. Results: One of the features that are common to most of the dictatorships is that the use of psychiatry has become more prominent when the regimes have had the need to make more acceptable the imprisonment of enemies in the eyes of the world. This for example happened in the Nazi regime when sterilization and killing of psychiatric patients was explained as a kind of euthanasia, or in the Soviet Union after the formal closure of the corrective labor camps and the slow resumption of relations with the capitalistic world, or in China to justify persecution of religious minorities and preserve economic relations with Western countries. Conclusion: Psychiatry has been variously used by totalitarian regimes as a means of political persecution and especially when it was necessary to make acceptable to public opinion the imprisonment of political opponents.