Anna Katharina Schaffner, Exhaustion: A History (New York: Columbia University Press, 2016), pp. i, 291, $30.00, hardback, ISBN: 978-0-231-17230-1.

In the end, then, the volume confirms that psychiatry in Communist Eastern Europe was moved by most of the same dilemmas and enthusiasms faced by its Western counterparts. Volker Hess, for instance, tells us that over-crowded facilities and a lack of funding for outpatient treatments, not party doctrine, were responsible for leading authorities in East Germany to rely on sedatives for handling institutionalised patients. And Mat Savelli reveals that in Yugoslavia, where professionals enjoyed a relatively large degree of independence from Moscow, psychiatrists looked to the West, not Pavlov, to draw inspiration for innovation. This being the case, it is left to consider where the future of historical studies of Eastern European psychiatry lies. After reading this book, two things come to mind. First, it is increasingly clear that Marxism-Leninism had only a very limited effect on the content of psychiatric thought. Where state socialism’s influence was most felt, instead, was in decision-making over the funding of mental health care. More research therefore needs to be done on the ways in which planned economies shaped the structure and consumption of psychiatric services. Second, given that it is now apparent that the ‘iron curtain’ hardly shielded Eastern European psychiatry from long-term trends and international forces of change, specialists in the field will need to conduct more comparative histories as well as studies that explore developments over lengthier periods of time.