Dr. Robertas Bunevicius: a pioneer of DSM in Lithuania
Juste Buneviciute
Dr. Robertas Bunevicius was always inquisitive and uncertain truths attracted his attention. While studying at Kaunas University of Medicine in late 1970’s he had difficulty connecting Freudian philosophy with a Soviet definition of “sluggish schizophrenia.” Even though both schools of thought had similarities: both systems erased a line between psychiatric disorder and health. According to Freud, we all have crazy thoughts and temptations, and it is normal; however, under the Soviet definition of “sluggish schizophrenia” we could put any originally thinking person and make him a psychiatric patient. In the Soviet Union, the diagnosis of “sluggish schizophrenia” was often used for political purposes to isolate dissenters or “radicals” not willing to accept occupation by placing them in mental health hospitals.
After Dr. Bunevicius received his medical doctor diploma in 1983, he completed internship and subsequently accepted an offer to work in a small public psychiatric hospital in Sveksna, Lithuania. Working independently from distinguished Soviet-Lithuanian psychiatrists allowed him to freely pursue his genuine curiosity. He was inspired by the change that occurred in psychiatry in 1980 when the American Psychiatric Association, published the Diagnostic and Statistical Manual for Mental Disorders (DSM-III). For the first time, an attempt was made to distance psychiatric illness from the theoretical reasoning. Psychiatric disorders were defined using strict diagnostic criteria. Based on these criteria, it was possible to standardize all psychiatric diagnoses, including schizophrenia. Not many people in USSR knew about this system, in fact, this book was considered anti-Soviet.
While working at the USSR Medical Sciences Academy, Endocrinology and Hormone Institute, he discovered a great opportunity to add standardized psychiatric evaluations to qualified endocrine database using DSM criteria. Psychoendocrinology became the main path of his medical research. He enjoyed combining medical fields: he merged psychiatry and endocrinology, later – immunology, cardiology, neurology, oncology, obstetrics, gynecology, and epigenetics. In Lithuania, Dr. Bunevicius established a group of young psychiatrists for a project – DSM-III criteria translation to Lithuanian. He took classes at Tartu University about DSM, which encouraged the team of young scientists to peruse this mission. Soon enough, in 1993, they translated and published DSM-III-R textbook in Lithuanian.
At first, Lithuanian psychiatry elite did not welcome the new textbook favorably, since this kind of psychiatry was too different from traditional Soviet nomenclature inspired psychiatry teaching. Eventually, the textbook was published using private funds and it did become the main textbook used in psychiatry until now.