SPECIAL CLASS: Classroom of the Elite

INTERMISSION 7: Psychiatric Evaluation

Psychiatric Evaluation

Name: Reina Ryuugu
Age: 13 years old
Date of Evaluation: September 15, 2021
Referring Institution: Sakuragaoka School, Mito, Ibaraki Prefecture, Kanto Region
Evaluator: Dr. Hiroshi Takamura, Clinical Psychiatrist

Reason for Evaluation:

Reina Ryuugu, 13 years old, was referred to the Mito Mental Health Medical Center by her school, Sakuragaoka School in Mito, following a violent incident. On September 9, 2021, Reina shattered several school windows before physically assaulting three classmates, resulting in injuries, including permanent blindness for one student. Her behavior has caused significant concern for her school and her family, prompting a comprehensive psychiatric evaluation.

Family Background and Developmental History:

Reina was born and raised in Hinamizawa, a rural village in Gifu Prefecture, before moving to Mito, Ibaraki Prefecture, at the age of 10. This move followed her father, who accompanied her mother for work-related reasons. Reina is the only child of divorced parents, with the divorce finalized in 2020, shortly before the incident. The parental separation had a profound impact on Reina, particularly when her mother began a relationship with a man named Akihito, whom she describes as an antagonistic figure in her life. Her mother also revealed that she was pregnant with Akihito's child, further straining Reina's relationship with her family.

Reina has shown increasing hostility toward her mother since this revelation, even going so far as to change her name. Born as "Reina," she decided to call herself "Rena," explaining that she wanted to erase the "i," which she associated with disgusting memories. This symbolic rejection also manifested in the destruction of objects related to her mother.

Psychiatric History:

There were no formal psychiatric records prior to this incident. However, since her parents' divorce, Reina has exhibited growing signs of emotional disturbance, including angry outbursts, obsessive ruminations, and self-harming behaviors. The patient has also reported hearing the voice of an entity she identifies as "Oyashiro-sama," a deity associated with her hometown of Hinamizawa. She firmly believes she is cursed for leaving the village and interprets these voices as divine instructions telling her to return to Hinamizawa.

Symptom History:

Since her parents' divorce, Reina has exhibited increasingly unusual behaviors. She has become obsessed with objects she perceives as "abandoned" or "needing a home." These objects, often simple trash or items of no value, are imbued with excessive emotional significance by Reina. She claims that the objects she collects are "lonely" and that it is her duty to save them.

In addition to these obsessive behaviors, Reina experiences recurrent auditory hallucinations. She frequently hears the voice of Oyashiro-sama, whom she associates with a protective yet vengeful divine figure. These hallucinations have intensified in recent months, exacerbating her violent and irrational behavior.

Another notable symptom is a somatic sensation of insects crawling under her skin, which Reina describes as unbearable. In response to this sensation, she has begun self-harming in hopes of relieving the "infestation." The self-inflicted wounds are mostly superficial but demonstrate growing emotional and psychological distress.