MARKAB MENTAL HEALTH FACILITY NUMBER 221995
Weight: 220 lbs
Referring Doctor: Smith, Damia; CMO
Transfer Notes: Careful watch, but do not confront. If patient exhibits signs of talking to himself administer stabilizers immediately. Usually is not violent, however this can change in an instant. Double check all security precautions and restraints before and after transfer begins. DO NOT ENGAGE IN CONVERSATION.
Patient Notes: Patient shows signs of dissociative identity disorder coupled with acute schizophrenia, without the usual paranoid delusions in most cases. Four distinct cases where a total break with reality reveals a nearly perfect test case for dissociative identity disorder being triggered by another mental condition. Patient begins to exhibit a second more dominant personality when audio hallucinations are engaged and interacted with. Will attempt to draw others into such conversations, which causes him to fall deeper into the delusion. The voice he hears often tries to advise others through him, making it difficult to tell when he is indulging the delusions. Sedatives and mental stabilizers will bring him around although with the added side effect that he becomes nearly vegetative.
Patient also exhibits extreme skill in slight of hand movements, these happen when a break with reality is imminent, unexplained events surrounding him should be treated as a warning sign. When under control and not indulging in the fantasy patient is calm and controlled as well as very friendly. Completely believes the voice he hears is the voice of god. Engaging him in discourse about this appears fruitful at first but fails.
If a break with reality occurs, patient will use deadly force with prejudice.
Comments: ((Hand Written in a thin precise hand))
He is a very friendly and honest man most of the time. However, I highly recommend he not be allowed to make friends with staff, when the voice gives him advice he passes it on without a sign that he is hearing a voice. The voice does not tell him to do disturbing things nor does it upset him in the least. He is completely friendly until the break with reality where he will kill when confronted without a thought. He shows definite signs of being able to torture and a complete repression of social constructs or restraint. I don't really believe in DID, I have no other explanation for him. Intelligence, mannerisms, voice, and dialect radically change. He becomes someone else entirely and when this happens the part of him that restrains doing what he wants or feels like doing is disconnected from the thought process. It is disturbing and dangerous, he has full memory of what happens but questioning him about what happens during a dissociative state can bring on another episode. I hope I never see the like again.
Transfer authorisation: Smith, Damia; CMO
FOR OFFICE USE ONLY