A fire in a rural psychiatric hospital in north west Russia that appears to have been caused by a patient either smoking or setting fire to himself has killed 37 people, authorities say.

The pre-dawn fire, which occurred in the village of Luka 137 miles south east of Saint Petersburg, is the latest tragedy to hit a mental institution in Russia and is likely to raise questions about the country’s management of mentally ill and vulnerable citizens.

One nurse is reported to have died while trying to save patients, while Russian media said that only 20 of the 59 people thought to be in the hospital were successfully evacuated.

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Russian television this morning showed images of the building reduced to smouldering wreckage.

In a statement the Russian Investigative Committee said the institution, which is made of wood brick and concrete, caught fire around 4.00am. A criminal probe has been launched to investigate suspected negligence.

A senior official said emergency authorities had recently tried to have the building condemned as unfit for use. Yuri Deshovykh, director of the Russian Emergency Situations Ministry's oversight department said:

“This building had a weak resistance to fire. It was made of wood. The administration had been told by the legal authorities to remedy numerous violations in fire security by August 1. But this was not done.”

The fire is the latest atrocity to occur in a poorly maintained Russian health or rehabilitation centre.

In April a fire that raged through a psychiatric hospital in the Moscow region killed 38 people - mostly patients engulfed by flames as they slept behind barred windows.

In 2006, a blaze in a Moscow drug clinic killed 45 women, with the local fire services facing criticism for their slow reaction to the incident.