March 28th 2018
Many thanks for referring mark.
He attended with his wife and
I saw him with my colleague
Carol
Murphy today
March 27th 2018 as you know
He has a serious an d significant history of childhood abuse and has
had extended periods of treatment in secondary care mental health
services in the past
This has included a range of psychological interventions
including a period of long -term and individual
psychotherapy.
As you see he was discharged from services but
feel that he needs additional support
at this point.
It seems that one trigger may be renewed interest
from the police following other evidence given
by a witness.
He is also experiencing abusive phone calls
from his father which he tries to avoid but
finds disturbing.
He is specifically looking for a time limited psy
chological intervention to help him address
the symptoms that he has now.
He recognizes that support with no clear en
d date would not be in his best interest.
Our intention is to ask our psychology colleagues
to review the case and consider whether to
offer further assessment.
He is aware that his past diagnoses have in
cluded emotionally unstable personality disorder,
depression and
PTSD.
He was previously assessed by the post -traumatic
stress disorder clinic in 2006 and offered
treatment but did not
take it up at that point.
He said he may be interested
in working with you and
DR now.
Having been off antidepressants for
some time he recently restarted
Sertraline and has been
on this in the past.
He says it has never really
helped him.
Sertraline can be used for
PTS D and you may want to try
a hydrate that the dose to see
if it is elective.
However it is not you could
consider switching to
Mirtazapine.
He says he has not tried this
in the past.
Murtazapine does get used for
PTSD and can help with sleep.
He does report sleep difficulties
so is interested in this.
He did not report any signific
ant physical health problems.
He said that whilst he has used alcohol significantly
in the past that he had not been drinking
for the past two months.
The breathalyzer did not show
any signs of alcohol today.