Dr. Clifford McDonald
Date of Exam: 3/18/2005 Time of Exam: 5:38:44 PM
Patient Name: O'Connor, Benjamin Patient Number: 10000124965435
History: Mr. O'Connor is a 19 year-old man born and raised in Milwaukee, WI. The chief concerns are homicidal ideations and repeated incidences of criminally violent activity. The following information was provided by: *Mr. O'Connor *Mr. O'Connor's family *Police reports Mr. O'Connor describes symptoms of an anxiety disorder, to which he finds relief from by the sight of blood. He recalls his symptoms beginning insidiously around the onset of puberty, shortly prior to his first conviction of aggravated assault. Mr O'Connor and his family have reported that he has no history of drug or alcohol use. Prior efforts to control anxiety with Klonopin have had little to no results.
Symptoms: 6:01:32 PM: We began by exposing Mr. O'Connor to violent imagery. 6:02:01 PM: Neuroscans show rapid increase in the release of dopamine, serotonin, endorphins, and norepinephrine. Mild increase in blood pressure. Patient is visibly elated and reports heavy wave of euphoria. 6:05:14 PM: Neuroactivity seems to stabilize, but endorphin activity remains constant. Blood pressure returns to normal. Patient seems calm and at peace, in spite of continued exposure to violent imagery. 6:21:33 PM: No changes in patient's vitals or neuroactivity. We cease exposure to violent imagery. 6:59:21 PM: Endorphin activity stabilizes. Patient seems calm and in control. Speech patterns normalize. Patient reports no symptoms of anxiety. Appetite seems to have returned. 8:02:12 PM: Patient reports no symptoms of anxiety, but is increasingly fidgety. Speech gradually reverts back to the typical fragmented pattern. 9:00:24 PM: Patient appears to be in the same psychiatric state as he was prior to his exposure to violent imagery.
General Notes: Mr. O'Connor's initial response to the sight of blood is not entirely unlike what one would expect from consumption of MDMA or methamphetamine. Excitement seems to last no more than a few minutes before Mr. O'Connor feels calm and at ease, in which his cognitive functions and social abilities resemble that of a normal functioning human being; effects last approximately three hours, whereupon symptoms of heavy anxiety return, comparable to withdrawal symptoms found in harder stimulants.
Diagnosis: We are wary of using the term, "psychopathy," as such a diagnosis is not sanctioned by our medical group nor any psychiatric association. More time is needed with patient.
Recommendation: Continued inpatient treatment is recommended until a diagnosis can be found. Given the neuroactivity of the patient, we will proceed with administration of Adderall. Start Adderall 10 mg PO QDS X 30days # 120 (one-hundred-twenty) Risk Factors Acute Grief: Death of father 1/21/1992 (victim of Jeffrey Dahmer); death of step-father 1/21/2005. 7102IC
Clifford McDonald, MD
Date of Exam: 3/18/2005 Time of Exam: 5:38:44 PM
Patient Name: O'Connor, Benjamin Patient Number: 10000124965435
History: Mr. O'Connor is a 19 year-old man born and raised in Milwaukee, WI. The chief concerns are homicidal ideations and repeated incidences of criminally violent activity. The following information was provided by: *Mr. O'Connor *Mr. O'Connor's family *Police reports Mr. O'Connor describes symptoms of an anxiety disorder, to which he finds relief from by the sight of blood. He recalls his symptoms beginning insidiously around the onset of puberty, shortly prior to his first conviction of aggravated assault. Mr O'Connor and his family have reported that he has no history of drug or alcohol use. Prior efforts to control anxiety with Klonopin have had little to no results.
Symptoms: 6:01:32 PM: We began by exposing Mr. O'Connor to violent imagery. 6:02:01 PM: Neuroscans show rapid increase in the release of dopamine, serotonin, endorphins, and norepinephrine. Mild increase in blood pressure. Patient is visibly elated and reports heavy wave of euphoria. 6:05:14 PM: Neuroactivity seems to stabilize, but endorphin activity remains constant. Blood pressure returns to normal. Patient seems calm and at peace, in spite of continued exposure to violent imagery. 6:21:33 PM: No changes in patient's vitals or neuroactivity. We cease exposure to violent imagery. 6:59:21 PM: Endorphin activity stabilizes. Patient seems calm and in control. Speech patterns normalize. Patient reports no symptoms of anxiety. Appetite seems to have returned. 8:02:12 PM: Patient reports no symptoms of anxiety, but is increasingly fidgety. Speech gradually reverts back to the typical fragmented pattern. 9:00:24 PM: Patient appears to be in the same psychiatric state as he was prior to his exposure to violent imagery.
General Notes: Mr. O'Connor's initial response to the sight of blood is not entirely unlike what one would expect from consumption of MDMA or methamphetamine. Excitement seems to last no more than a few minutes before Mr. O'Connor feels calm and at ease, in which his cognitive functions and social abilities resemble that of a normal functioning human being; effects last approximately three hours, whereupon symptoms of heavy anxiety return, comparable to withdrawal symptoms found in harder stimulants.
Diagnosis: We are wary of using the term, "psychopathy," as such a diagnosis is not sanctioned by our medical group nor any psychiatric association. More time is needed with patient.
Recommendation: Continued inpatient treatment is recommended until a diagnosis can be found. Given the neuroactivity of the patient, we will proceed with administration of Adderall. Start Adderall 10 mg PO QDS X 30days # 120 (one-hundred-twenty) Risk Factors Acute Grief: Death of father 1/21/1992 (victim of Jeffrey Dahmer); death of step-father 1/21/2005. 7102IC
Clifford McDonald, MD