The Psychiatric Report is the thirtieth and final clue in the Mystery Man Clueline. It can be found by Sam in the lodge's basement, in Chapter 7 of Until Dawn.
Overview[]
A comprehensive report on Josh, elaborating on all his previous experiences with psychiatric treatment and medication.
Transcript[]
Cover Page[]
OCEAN VIEW HOSPITAL
HEALTH AND HAPPINESS
FINAL PSYCHIATRIC EVALUATION
05/21/2014
DR. A. HILL
CONFIDENTIAL
Physician History[]
06/11/2006
Jeremy Harris, MD
Whale Point Surgery
Referred on 04/02/2007 after incident at school
04/26/2007
Oliver Purkiss, MD, MPH
Pastoral Wellbeing Center
Referred on 10/19/2009 after incident at school
10/23/2009
Roisi Williams, MD
Santa Buena Medical Center
Referred on 12/09/2009 after disagreement over treatment
01/03/2010
Sarah North, MD, PhD
Cranleigh Hospital
Referred on 11/29/2013 after patient's response to drugs tapered badly
12/19/2013 - Present
Alan Hill, MD, MPH
South-Western Psychiatry
Referred on 03/14/2014 due to potential suicide risk
History of Prescribed Antidepressants[]
Fluoxetine (06/18/2006 - 01/24/2010)
Patient reported that side-effects (headaches, nausea) were becoming too severe, and wanted to change drug.
Duloxetine (02/13/2010 - 11/01/2013)
Patient claimed that the drug was no longer having any effect. Reported that his mood had badly worsened.
Amitriptyline (11/29/2013 - 04/05/2014)
Patient began self-medicating, taking stronger doses.
Phenelzine (04/15/2014 - present)
30mg dose. Twice daily, increasing to three times daily after 2 weeks.
If the patient reports any of the following symptoms, please contact a physician IMMEDIATELY.
Side effects: hypotension, blurred vision, dizziness, insomnia, vomiting, diarrhea, muscle tremors, liver damage (hepatitis),
On withdrawal: nausea, insomnia, nightmares, agitation, hallucinations, paranoia, aggressiveness, slurred speech, ataxia, catatonia, shocks
Summary of Treatment[]
Patient arrived delirious/confused. Strong symptoms of major depressive disorder, related to death/disappearance of sisters.
Placed patient under observation.
ECT was considered, given patient's history of tapering drug effects, but rejected.
CBT, IPT, psychoanalysis, etc, failed to produce any improvement.
New course of drugs was necessary.
Patient moved onto a non-selective MAOI. Rationale being that SSRIs and SNRIs have proven ineffective in the past.
Phenelzine 60mg initially. Higher than average dose was necessary to see reduction of symptoms.
After 2 weeks, patient's symptoms and mood were greatly improved.
Discharged on 16th May after final consultation proved satisfactory.
Dr. Alan Hill
Invoice[]
OCEAN VIEW HOSPITAL
DATE: 05/16/2014
INVOICE #5132
1 Pinnacle Drive
Pacific Road
CA 90187
SHIP TO
Washington Pictures Incorporated
Valley Town
Burbank
CA 90321
| QTY. | TREATMENT | RATE | AMOUNT |
|---|---|---|---|
| 30 | Nights residence (observed) | 395 | 11850.00 |
| 1 | Phenelzine (200x 15mg) | 105.24 | 105.24 |
| 1 | Initial Consultation | 750 | 750.00 |
| 14 | Review Consultation (1 hour) | 595 | 8330.00 |
| 7 | CBT (1 hour) | 745 | 5215.00 |
TOTAL: 26250.24
PAYMENTS/CREDITS: 0.00
BALANCE DUE: $26250.24
Location[]
After entering the Psycho's workshop, walk to the desk on your right side and open up the drawer.
Trivia[]
- This clue can only be found by Sam if she escaped from the Psycho in Chapter 5.
- Hannah's Diary states Josh went to a hospital.
- This clue foreshadows the diminishing sanity of Josh, as he starts suffering the same drug withdrawal effects mentioned in the Journal later in the game.
- The drugs that were prescribed to Josh are all focused around serotonin, a kind of neurotransmitter. Depression can be triggered, if there is a decrease of production of serotonin.
- Fluoxetine is a SSRI which stands for "selective serotonin re-uptake inhibitor", and this can help increase serotonin in the brain.
- Duloxetine is a selective serotonin/norepinephrine re-uptake inhibitor.
- Amitriptyline and Phenelzine are the earliest anti-depressants developed.
- The list of doctors Josh had seen before Hill comes from the names of developers who worked on the game.
- Jeremy “Jez” Harris was a production manager.
- Oliver “Ollie” Purkiss was on the design team.
- Sarah North was on the animation team.
Speculation[]
There are two theories:
- Josh was properly diagnosed and his symptoms in the game were the withdrawal symptoms of the above medications, as mentioned in the report, which line up with his behavior.
- The drugs that he took were effective, but for his depression only, and ineffective for other mental illnesses he might have had that went undiagnosed.