The Soviet system used psychiatry as a weapon by diagnosing political opponents as mentally ill in order to confine them as patients instead of trying them in court. Anyone who challenged the state such as dissidents, writers, would-be emigrants, religious believers, or human rights activists could be branded with fabricated disorders like sluggish schizophrenia. This turned normal political disagreement into supposed medical pathology and allowed the state to present dissent as insanity.
Once labeled in this way, people were placed in psychiatric hospitals where they could be held for long periods without legal protections. Harsh treatments were often used to break their resolve. The collaboration between state security organs and compliant psychiatrists created a system where political imprisonment was disguised as medical care, letting the Soviet regime suppress opposition while pretending it was addressing illness rather than silencing critics.
Strong disagree on sociopathy being linked to a hierarchy.
The reality is that pretty much EVERY system of governance (that is meant to scale beyond five people in a field) needs a hierarchy of some form. Its the Whitest Kids U Know gag on anarchy where you quickly find out that there are people better suited to certain jobs and you need some degree of a social safety net to allow them to keep all of you alive (n that case, keeping a nuclear power plant from melting down… and then making t-shirts).
It is why there are basically no flat Democracies. You inherently end up in some form of a Democratic Republic where The People elect representatives who can then (theoretically) spend all day educating themselves on important issues and figuring out how to make an educated vote that represents the will of their constituents.
The core concept is just the reality of needing special skills and knowledge to make many decisions. There can be arguments that the people in charge of Directing The Military are still equal to the custodial staff keeping the streets clean but… moving on.
Where sociopathy comes into play is that those roles tend to inherently attract power mad people (there is a DIFFERENT WKUK gag on this…). But hierarchical systems are a natural knock on from just having to have a socioeconomic system that scales.