Psychiatric Disorders / Mental Health Conditions

Depression, Generalised Anxiety Disorder, Post-Traumatic Stress Disorder (PTSD), Panic Disorder, Obsessive Compulsive Disorder (OCD), Hypochondriasis, Somatoform Disorders, Psychosomatic Symptoms, Personality Disorders, Psychosis.

As general adult psychiatrists we are proficient in identifying, assessing and evaluating risk across the range of adult psychiatric disorders including mood, anxiety, post-traumatic and somatoform disorders.

We have extensive experience in conducting detailed psychiatric assessments and reporting to referring colleagues or the courts; also delivering clinical treatment. Mental Disorders are common and often poorly understood by non-specialists. We have extensive experience in teaching medical and other clinical colleagues and engaging the public in understanding mental disorder.

Psychiatric Consequences of Physical Injury and Disease

Depression, anxiety, PTSD, Dissociation, Somatoform Disorders, Self-Harm and Suicide, Mild Brain Injury caused by physical injury and disease, including spinal cord and peripheral nerve injury

Physical injuries often carry psychiatric consequences such as anxiety, depression, post-traumatic stress disorder and alcohol and substance use disorders which can be more devastating and persistent than the physical injury.

We routinely conduct assessments to illuminate these invisible consequences, including endeavouring to distinguish genuine from feigned symptoms and reporting to referring colleagues or the courts. Sometimes physical injury and disease may arise because of mental disorders (e.g. deliberate self harm, poor nutrition, substance misuse) and it is important to outline the relative importance of pre-existing problems, compared to problems caused by injury and disease. Our work at the Royal National Orthopaedic Hospital engages us regularly in the care of patients with orthopaedic, spinal cord and peripheral nerve injuries. 

Psychiatric Aspects of Chronic Pain

Complex Regional Pain Syndrome (CRPS), Joint Hypermobility/ Ehlers Danloss Syndrome Type III, recurrent shoulder dislocation, fibromyalgia

Chronic pain often co-occurs with mental disorder, which can be the cause, co-morbidity or consequence of chronic pain. There is a well-established association between chronic pain and complex mental health problems such as childhood maltreatment, generalised anxiety disorder, personality disorders and severe psychosocial stressors.

We are recognised widely as experts in unravelling relevant factors in individual cases and formulating simple or complex plans, depending on the case, and reporting to referring colleagues or the courts. We conduct regular inpatient and outpatient clinical work with people with chronic pain and meet regularly with pain physicians and members of the multidisciplinary team to provide widely applauded clinical treatment to such patients.

Medically Unexplained Symptoms (MUS) / Somatisation

Somatoform disorders, Somatic Symptom Disorder, Hypochondriasis, Psychosomatic Symptoms, Conversion Disorders, Dissociation, Psychological Factors Associated with Diseases Elsewhere Classified, Exaggeration and Malingering 

Medically Unexplained Symptoms (MUS) is an umbrella term used to refer to physical symptoms in the absence of a diagnosed physical disease and “somatisation” refers to the phenomenon of reacting to psychological stress primarily with physical symptoms.

Thorough psychiatric evaluation is essential for the full understanding of these common phenomena and their significance, whether clinical or medicolegal and we routinely conduct relevant assessments and report to referring colleagues or the courts; also carry out relevant treatments. MUS/ Somatisation is frequently underappreciated by other clinical specialists leading to misattribution and inappropriate and sometimes harmful care

Personal Injury, Medical Accidents and Clinical Negligence 

Psychiatric aspects of accidents at work or in public spaces, bullying and harassment, gun-shot injuries, victims of terrorist attacks, surgical and medical negligence

Unfortunately, bullying, assaults, medical and other accidents and clinical negligence occur. We are familiar with these both in our routine clinical work and medicolegal work and can advise and treat accordingly. With respect to medical accidents and clinical negligence, this includes patients treated in either the NHS or the private sector. Between us, we have over 25 years’ experience in providing relevant reports to the courts, insurers, compensation schemes and employers. 

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Our medicolegal reports are based on an examination of medical files or other relevant documentation and a psychiatric assessment conducted in person. The report will address your client’s psychiatric state and is designed to answer any specific questions relevant to their case. We convey our findings and conclusions in a way that is easily understood. We have experience of giving evidence in court, and our arguments are balanced, robust and logical.

We would be happy to provide an estimate of the cost of an individual report, based upon its likely complexity, in advance. A statement of account will be sent with the completed report and payment will become due within 30 days of invoice. Court attendance, prison visits and examination of clients outside of the UK are all by special arrangement. For further details of our fees for clinical negligence and personal injury reports, along with full terms and conditions, please contact PsyPex directly.